Haemodynamic comparison of propofol-fentanyl anaesthesia with midazolam-fentanyl anaesthesia in CABG patients without preoperative heart failure.
This study was designed to compare prebypass haemodynamics under total intravenous anaesthesia (TIVA) using midazolam-fentanyl (group M) and propofol-fentanyl (group P) combinations. Sixteen adult patients undergoing CABG were studied with patients in group M and P (n = 8 each) given intravenous midazolam 0.1 mg.kg-1.h-1 and propofol 4 mg.kg-1.h-1 with fentanyl 25 micrograms.kg-1 until sternotomy, respectively. Following induction of anaesthesia, cardiac index and heart rate decreased significantly (30% and 20% in both groups, p < 0.05) these variables returned to baseline on completion of sternotomy. In addition, in group P mean arterial pressure decreased significantly (about 15%) following induction and there were no ischaemic signs. Overall for MAP there was no significant difference between the two groups. LVSWI and RVSWI were reduced by around 25% in both groups. Only the change in LVSWI reached statistical significance (p < 0.05). This reduction may have exert a caridioprotectant action by decreasing myocardial oxygen consumption. We conclude that both TIVA techniques represent an acceptable anaesthetic regimen for use in cardiac anaesthesia.
Kubota
T
T
Department of Anesthesiology, University of Hirosaki School of Medicine, Hirosaki, 036-8562, Japan.
Hirota
K
K
Yoshida
H
H
Yatsu
Y
Y
Maeda
A
A
Matsuki
A
A
D000368:Aged; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D001026:Coronary Artery Bypass; D005260:Female; D005283:Fentanyl; D006333:Heart Failure / Q000150:complications; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D015742:Propofol
D018686:Anesthetics, Intravenous; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol