Propofol and fentanyl anaesthesia for patients with low cardiac output state undergoing cardiac surgery: comparison with high-dose fentanyl anaesthesia

• Published in: British Journal of Anaesthesia 1994-08, Vol.73 (2), p.162-166
• Main Authors: BELL, J., SARTAIN, J., WILKINSON, G.A.L., SHERRY, K.M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anaesthetic techniques:i.v; Anaesthetics; Anaesthetics, i v.:propofol; Analgesics; Analgesics, opioid: fentanyl; Anesthesia Recovery Period; Anesthesia, Intravenous - methods; Anesthetics. Neuromuscular blocking agents; Biological and medical sciences; Cardiac Output, Low - physiopathology; Cardiac Surgical Procedures; Cardiopulmonary Bypass; Drug Administration Schedule; Female; Fentanyl - administration & dosage; Heart Rate - drug effects; Hemodynamics - drug effects; Humans; i v.:propofol; Male; Medical sciences; Middle Aged; Neuropharmacology; opioid: fentanyl; Pharmacology. Drug treatments; Propofol - administration & dosage; Surgery: cardiovascular
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/73.2.162

We have compared the haemodynamic effects of an infusion of propofol 8mg kg−1 h−1 followed by 4mg kg−1h−1 and fentanyl 15μg kg−1 (group 1) with midazolam 3–6mg and fentanyl 60 μg kg−1 (group 2) in patients with a low cardiac output state undergoing cardiac surgery. Heart rate was lower in group 1 throughout the period before cardiopulmonary bypass. There were no significant differences between the groups in other measured variables. Arterial pressure decreased in both groups after induction, by 21% in group 1 and 18% in group 2. Thermodilution assessment of right ventricular ejection fraction was unchanged. Myocardial contractility was not affected adversely. Patients in group 1 who received an infusion of propofol and a smaller dose of fentanyl awakened sooner and the trachea was extubated earlier.