Hemodynamic effects of fentanyl and sufentanil combined with flunitrazepam in coronary artery surgery

• Published in: Annales françaises d'anesthésie et de réanimation Vol. 7; no. 6; p. 471
• Main Authors: Videcoq, M, Desmonts, J M, Depoix-Joseph, J P, Malbezin, S, Hazebroucq, J, Barbier-Böhm, G, Flaisler, B
• Format: Journal Article
• Language: French
• Published: France 1988
• Subjects: Aged; Analgesics - pharmacology; Coronary Artery Bypass; Drug Combinations; Female; Fentanyl - analogs & derivatives; Fentanyl - pharmacology; Flunitrazepam - pharmacology; Hemodynamics - drug effects; Humans; Male; Middle Aged; Sufentanil
• ISSN: 0750-7658; 1769-6623

Because sufentanil has been reported as being able to prevent or treat peroperative hypertensive crises during aorto-coronary artery graft surgery, a study was carried out to compare the haemodynamic effects of sufentanil with those of fentanyl. 20 patients who were to undergo aortocoronary bypass grafting (CABG) were randomly allocated to two equal groups, sufentanil (Sf) and fentanyl (F) groups. A 1 to 5 dose ratio was used so as to have equipotent doses of sufentanil and fentanyl. Induction doses were 10 micrograms.kg-1 sufentanil and 50 micrograms.kg-1 fentanyl. Up to 20 micrograms.kg-1 sufentanil and 100 micrograms.kg-1 fentanyl were then used between intubation and the setting-up of cardiopulmonary bypass (CPB). A bolus of 10 micrograms.kg-1 flunitrazepam was given if necessary, so as to lower the mean arterial pressure (Pa) to below 100 mmHg after intubation, and under 80 mmHg during CPB. Heart rate, Pa, mean pulmonary arterial pressure, pulmonary wedge pressure (Ppw), central venous pressure and cardiac output were measured before anaesthesia, 2 min after intubation, before incision, 2 min after sternotomy, 10 min after the end of CPB, after chest closure, 30 min and 2h after arrival of the patient in the intensive care unit. The only difference found between the two groups was a more rapid drop in left ventricular preload after induction with sufentanil; 2 min after intubation, there was a 26% fall in Ppw with sufentanil (p less than 0.01) and 8% with fentanyl. Before skin incision, this drop was of 32% (p less than 0.01) and 24% (p less than 0.01) respectively.