title: Comparison of two different anesthesia regimens in patients undergoing aortocoronary bypass grafting surgery: sufentanil-midazolam versus remifentanil-propofol.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Lehmann
authors.forename: C
authors.initials: C
authors.lastname: Zeitler
authors.forename: E
authors.initials: E
authors.lastname: Thaler
authors.forename: F
authors.initials: F
authors.lastname: Isgro
authors.forename: J
authors.initials: J
authors.lastname: Boldt
mesh_terms: 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
chemical_list: D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D010880:Piperidines; D017409:Sufentanil; D000077208:Remifentanil; D008874:Midazolam; D015742:Propofol