Evaluation of remifentanil anesthesia for off-pump coronary artery bypass grafting surgery using heart rate variability

Heart rate variability (HRV) was used in the present study to evaluate a target-controlled approach compared with a constant-rate infusion for remifentanil anesthesia during off-pump coronary artery bypass grafting (OP-CABG) surgery. A total of 65 patients with American Society of Anesthesiologists...

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Bibliographic Details
Published in:Experimental and therapeutic medicine 2013-07, Vol.6 (1), p.253-259
Main Authors: SHU, AIHUA, ZHAN, LEYUN, FANG, HAIBIN, LV, EN, CHEN, XIAOBO, ZHANG, MINGYU, WANG, QIANG
Format: Article
Language:English
Subjects:
Anesthesia
Angina pectoris
Cardiac arrhythmia
Cardiovascular disease
Coronary vessels
Electrocardiography
Heart rate
heart rate variability
Heart surgery
Hypertension
Mortality
Nervous system
off-pump coronary artery bypass grafting
remifentanil
Stress response
target-controlled infusion
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Summary:Heart rate variability (HRV) was used in the present study to evaluate a target-controlled approach compared with a constant-rate infusion for remifentanil anesthesia during off-pump coronary artery bypass grafting (OP-CABG) surgery. A total of 65 patients with American Society of Anesthesiologists (ASA) physical status II or III, who were aged 60-85 years and scheduled for OP-CABG, were selected for the study. All patients were administered an intramuscular premedication of 10 mg morphine and 0.3 mg scopolamine. In group I, remifentanil was infused using a target-controlled approach at 1.5-5.0 ng/ml, and in group II, remifentanil was infused at a constant-rate of 0.05-1.0 μg/kg/min and at additional single increments of 1 μg/kg when appropriate. The heart rate and other hemodynamic monitoring indices of the patients, including the mean arterial pressure, central venous pressure, pulmonary artery pressure and pulmonary capillary wedge pressure, were monitored at various time points, including prior to induction (T0), at extubation (performed intraoperatively; T7) and at 24 h post-surgery. The HRV indices, including total power (TP), low frequency (LF) and the LF/high frequency (HF) ratio of power (LF/HF), were reduced following induction at T0 and remained low at 24 h post-surgery. At T5 (right coronary or left circumflex artery anastomosis) and T7 (tracheal extubation), all the HRV indices, with the exception of the HF power, were significantly increased (P
ISSN:1792-0981
1792-1015
DOI:10.3892/etm.2013.1108