Comparison of two different anesthesia regimens in patients undergoing aortocoronary bypass grafting surgery: sufentanil-midazolam versus remifentanil-propofol.
OBJECTIVE
To compare intraoperative hemodynamics and depth of anesthesia using sufentanil-midazolam (SM) versus remifentanil-propofol (RP) anesthesia.


METHODS
Prospective, randomized study.


METHODS
Clinical investigation in an urban, university-affiliated hospital.


METHODS
Forty patients undergoing elective first-time coronary artery bypass graft surgery.


METHODS
Twenty patients were anesthetized using SM and 20 patients using RP.


RESULTS
Hemodynamic monitoring included a 5-lead electrocardiogram, a radial artery catheter, and a pulmonary artery catheter. Depth of anesthesia was assessed using bispectral index (BIS). Data were obtained after induction of anesthesia (T1), after sternotomy (T2), after pericardiotomy (T3), 5 minutes after cardiopulmonary bypass (CPB) (T4), after closure of thorax (T5), and at the end of surgery (T6). The 2 groups were comparable with regard to demographic and perioperative data. There were no significant differences of any hemodynamic parameter at any time between the 2 groups. In both groups, systemic vascular resistance increased at T2 and decreased at T4 from baseline value (p < 0.05). Cardiac index increased at T4 in both groups from baseline value (p < 0.05); 55% of the patients of both groups needed low-dose dobutamine after CPB. During CPB, 40% of the RP patients needed norepinephrine versus 35% of the SM patients. BIS was lower in the RP than in the SM group at T2 and T3 (p < 0.05). BIS values indicating intraoperative awareness were not noted.


CONCLUSIONS
Both anesthesia regimens provided stable hemodynamics and adequate anesthesia in patients undergoing coronary artery bypass graft surgery.
Lehmann
A
A
Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Germany.
Zeitler
C
C
Thaler
E
E
Isgro
F
F
Boldt
J
J
D000368:Aged; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D001026:Coronary Artery Bypass; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008874:Midazolam; D010880:Piperidines; D015742:Propofol; D011446:Prospective Studies; D000077208:Remifentanil; D017409:Sufentanil
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D010880:Piperidines; D017409:Sufentanil; D000077208:Remifentanil; D008874:Midazolam; D015742:Propofol