Myocardial metabolism and hemodynamic responses with fentanyl-enflurane anesthesia for coronary arterial surgery. 1986

E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley

Ten patients for coronary vein grafting had induction of anesthesia with fentanyl (30 micrograms/kg), followed by enflurane-oxygen sufficient to decrease systolic blood pressure by 27% before intubation. Enflurane was continued in concentrations to maintain blood pressure below that with patients awake. All patients had preserved ventricular function and effective beta-blockade. Studies of hemodynamic functions and myocardial blood flow and oxygenation were done before induction, six times during anesthesia, and twice postoperatively. The blood pressure decrease on induction and before bypass was due to reduced cardiac index without decreased heart rate or systemic resistance. Stroke work index decreased 47% on induction and remained below awake level throughout. Coronary sinus blood flow decreased 26% after intubation and remained so before bypass. Without change in coronary resistance, coronary sinus oxygen content increased 30% on induction and stayed elevated before bypass. Normal lactate extraction continued after induction and increased before bypass; mean extraction decreased after bypass, with one or two hearts producing lactate in the first 24 postoperative hr. Fentanyl-enflurane-oxygen maintained a steady mild hemodynamic depression during the operation and soon afterward, which preserved myocardial oxygenation.

UI MeSH Term Description Entries
D007773 Lactates Salts or esters of LACTIC ACID containing the general formula CH3CHOHCOOR.
D008297 Male Males
D009204 Myocardial Revascularization The restoration of blood supply to the myocardium. (From Dorland, 28th ed) Internal Mammary Artery Implantation,Myocardial Revascularizations,Revascularization, Myocardial,Revascularizations, Myocardial
D009206 Myocardium The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow. Muscle, Cardiac,Muscle, Heart,Cardiac Muscle,Myocardia,Cardiac Muscles,Heart Muscle,Heart Muscles,Muscles, Cardiac,Muscles, Heart
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D011229 Preanesthetic Medication Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic. Medication, Preanesthetic,Medications, Preanesthetic,Preanesthetic Medications
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D003326 Coronary Circulation The circulation of blood through the CORONARY VESSELS of the HEART. Circulation, Coronary
D004737 Enflurane An extremely stable inhalation anesthetic that allows rapid adjustments of anesthesia depth with little change in pulse or respiratory rate. Alyrane,Enfran,Enlirane,Ethrane,Etran
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263

Related Publications

E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
January 1986, Anesthesia and analgesia,
E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
November 1984, Canadian Anaesthetists' Society journal,
E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
December 1982, Anesthesia and analgesia,
E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
February 1992, Masui. The Japanese journal of anesthesiology,
E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
January 1984, Annales francaises d'anesthesie et de reanimation,
E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
December 1984, Anesthesia and analgesia,
E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
May 1986, Anesthesia and analgesia,
E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
January 1986, Der Anaesthesist,
E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
March 1988, Masui. The Japanese journal of anesthesiology,
E A Moffitt, and A J McIntyre, and R A Barker, and D D Imrie, and D A Murphy, and R W Landymore, and C E Kinley
October 2005, Journal of cardiothoracic and vascular anesthesia,
Copied contents to your clipboard!