The Hemodynamic Effects of Sevoflurane Anesthesia During Induction and Early Maintenance for Coronary Artery Bypass Graft Surgery: Compared with Fentanyl-Midazolam/Isoflurane Anesthesia.
10.4097/kjae.2004.46.1.65
- Author:
Sun Ho HWANG
1
;
Dong Gun LIM
;
Si Oh KIM
;
Woon Yi BAEK
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, Kyungpook National University, Daegu, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
CABG;
fentanyl;
hemodynamic change;
midazolam;
isoflurane;
sevoflurane
- MeSH:
Anesthesia*;
Arterial Pressure;
Coronary Artery Bypass*;
Coronary Vessels*;
Electrocardiography;
Fentanyl;
Heart Rate;
Hemodynamics*;
Humans;
Intubation;
Isoflurane;
Metabolome;
Midazolam;
Oxygen;
Pulmonary Wedge Pressure;
Vecuronium Bromide
- From:Korean Journal of Anesthesiology
2004;46(1):65-71
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Sevoflurane is the most recently available volatile agent which permits the rapid induction with its nonirritant nature. The goal of this study was to compare the hemodynamic responses of sevoflurane induction and maintenance period with those of fentanyl-midazolam/isoflurane anesthesia for CABG. METHODS: Twenty-eight patients who underwent CABG were given anesthesia, and were randomly assigned to receive sevoflurane (Sevo Group, n = 15) or fentanyl-midazolam/isoflurane (Iso-Fent Group, n = 13), as induction and maintenance agents. In the Sevo group, anesthesia was induced with two or three deep breaths of 7.5% sevoflurane, and maintained with 2% sevoflurane after intubation. The Iso-Fent Group received fentanyl 5microgram/kg and midazolam 0.2 mg/kg with oxygen for induction and maintained with 0.8% isoflurane and 5microgram/kg/hr of fentanyl by infusion. All were given vecuronium as a muscle relaxant. Cardiac and oxygen metabolic profiles were measured before and 10 minutes after tracheal intubation. RESULTS: Before induction, there was no difference between Sevo and Iso-Fent group in terms of cardiac and oxygen metabolic profiles. After intubation, mean arterial pressure, mean pulmonary arterial pressure, pulmonary capillary wedge pressure, heart rate and mixed venous oxygen saturation in the Sevo group were higher than in the Iso-Fent group (P < 0.05). The ST-segment changes in the EKG monitoring was unremarkable during anesthesia induction in either group. CONCLUSIONS: For the induction and early anesthesia maintenance in patients undergoing CABG surgery, sevoflurane may be a substitute for fentanyl-midazolam/isoflurane without any significant hemodynamic changes.
