Alfentanil and sufentanil in fast-track anesthesia for coronary artery bypass graft surgery.
OBJECTIVE
To evaluate alfentanil, sufentanil, and the combination of both opioids in patients undergoing cardiac surgery.


METHODS
Prospective, randomized study.


METHODS
University hospital.


METHODS
Patients undergoing coronary artery bypass graft (CABG) surgery (n = 195), randomly assigned to 3 groups of 65 each.


METHODS
Patients in group A received alfentanil, induction (15 microg/kg) and maintenance (15 microg/kg/hr); patients in group S received sufentanil, induction (1 microg/kg) and maintenance (1 microg/kg/h); and patients in group AS received alfentanil and sufentanil, induction with alfentanil (15 microg/kg) and maintenance with sufentanil (1 microg/kg/hr).


RESULTS
Hemodynamic data showed a reduction of all parameters at induction in the 3 groups (p < 0.05). Cardiac index decreased at induction in all groups (p < 0.05) but increased in groups S and AS toward baseline values at the end of surgery. The intubation time and length of stay in the intensive care unit were less in group AS (2.3 +/- 1.2 hours; p < 0.001 and 20 +/- 8 hours; p < 0.05), than in groups A (4.2 +/- 1.7 hours and 28 +/- 13 hours) and S (3.1 +/- 1.1 hours; p < 0.05 and 26 +/- 12 hours). Length of hospital stay and patients' outcome were similar in the 3 groups.


CONCLUSIONS
Although the differences among groups regarding extubation time, intensive care unit length of stay, and some hemodynamic data were statistically significant, the differences were clinically small. All 3 anesthetic protocols were shown to be safe and appropriate for patients undergoing elective coronary artery bypass graft surgery and early postoperative tracheal extubation.
Tritapepe
Luigi
L
Department of Anesthesia, University of Rome La Sapienza, Rome, Italy. tritaluigi@libero.it
Voci
Paolo
P
Di Giovanni
Claudio
C
Pizzuto
Francesco
F
Cuscianna
Enrica
E
Caretta
Quintilio
Q
Pietropaoli
Paolo
P
D000368:Aged; D015760:Alfentanil; D000701:Analgesics, Opioid; D000758:Anesthesia / Q000379:methods*; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017409:Sufentanil
D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D015760:Alfentanil; D017409:Sufentanil