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The effects of sufentanil (0.7 microgram/kg) and fentanyl (7 microgram/kg) on general and coronary haemodynamics and myocardial metabolism were studied in 6 and 9 patients without cardiovascular disease. Both drugs produced a slight reduction in heart rate, cardiac index and mean aortic pressure, whilst peripheral vascular resistance remained unchanged. There was a decrease in dp/dtmax and a slight increase in LVEDP suggesting minimal depression of myocardial contractility. Myocardial blood flow and myocardial oxygen uptake slightly decreased due to reduction in pressure-, volume- and frequency-load and dp/dtmax. With both drugs arterial concentrations of glucose, lactate, pyruvate and free fatty acids and their myocardial uptake did not change significantly. Clinically equi-anaesthetic doses of sufentanil and fentanyl produced almost identical effects on general and coronary haemodynamics. With regard to the cardiovascular actions sufentanil offers no advantage over fentanyl.
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