Fentanyl oxygen anaesthesia for abdominal aortic surgery

• Published in: Canadian Anaesthetists' Society Journal Vol. 33; no. 6; pp. 719 - 722
• Main Authors: FRIESEN, R. M, THOMSON, I. R, HUDSON, R. J, ROSENBLOOM, M, PUTNINS, C. L, CANNON, J. E
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Toronto, ON Canadian Anaesthetists' Society 01.11.1986
• Subjects: Aged; Anesthesia; Anesthesia depending on type of surgery; Anesthesia, General - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aorta, Abdominal - surgery; Biological and medical sciences; Electrocardiography; Female; Fentanyl; Hemodynamics - drug effects; Humans; Male; Medical sciences; Middle Aged; Oxygen; Respiration - drug effects; Thoracic and cardiovascular surgery. Cardiopulmonary bypass; Abdominal aorta; Human; General anesthesia; Surgery; Blood vessel
• ISSN: 0008-2856; 1496-8975
• DOI: 10.1007/BF03027120

Patients who present for abdominal aortic surgery often have significant atherosclerotic disease which may involve the coronary arteries. Haemodynamic responses occurring during fentanyl (100 micrograms X kg-1) oxygen anaesthesia for abdominal aortic surgery were studied in 16 patients. Anaesthesia was induced with fentanyl 100 micrograms X kg-1 with no supplemental doses and metocurine-pancuronium mixture (4:1). In 13 of 16 patients hyperdynamic circulatory responses to surgical stimuli required treatment prior to aortic cross-clamping. Interventions instituted were sodium nitroprusside or nitroglycerin (n = 13), propranolol (n = 4), and diazepam (n = 4). The serum fentanyl concentration at time of response to surgical stimulus was 18.5 +/- 5.6 ng X ml-1 (range 7-27 ng X ml-1; time from induction 71 +/- 49 min, n = 9). Eleven of the 16 patients required treatment for postoperative hypertension. Five of the 16 patients developed myocardial ischaemia, defined as ST segment depression greater than 0.1 mV, at some time during the operative procedure. Unsupplemented fentanyl anaesthesia (100 micrograms X kg-1) was unable to maintain a hypodynamic circulation in patients having abdominal aortic operations.