Oxygen-high dose fentanyl-droperidol anesthesia for aortocoronary bypass surgery. 1981

L Quintin, and D G Whalley, and J E Wynands, and J E Morin, and R Mayer

Ten patients undergoing aortocoronary bupass surgery were studied during induction of anesthesia and during initial surgical stimulation. Each patient was anesthetized with fentanyl, 100 micrograms/kg, droperidol, 0.15 mg/kg, and pancuronium, 0.1 mg/kg, and ventilated with 100% oxygen. Preoperative medication consisted of propranolol, nitrate preparations, diazepam, 0.15 mg/kg orally, morphine, 0.15 mg/kg IM, and scopolamine, 0.4 mg IM. Intravenous, arterial, and Swan-Ganz catheters were inserted under local anesthesia after which control measurements of hemodynamic parameters and arterial blood gas tensions were taken. Observations were repeated after fentanyl, 50 micrograms/kg, after endotracheal intubation, after another dose of fentanyl, 50 micrograms/kg, after skin incision, and after sternotomy. The total dose of droperidol was given incrementally throughtout the fentanyl infusion. Normal saline was infused to maintain constant pulmonary capillary wedge pressure. Heart rate, left ventricular stroke work index, triple index, pulmonary capillary wedge pressure, and PaCO2 remained constant throughout the study. Systolic blood pressure decreased significantly after fentanyl, 50 micrograms/kg, and initial administration of droperidol, but thereafter remained unchanged. Stroke index increased significantly after fentanyl, 50 micrograms/kg, and remained elevated at all subsequent intervals. Cardiac index increased after fentanyl, 50 micrograms/kg and 100 micrograms/kg. Rate-pressure product was stable until the time of sternotomy after which it decreased significantly. In patients undergoing aortocoronary bypass surgery, 100% oxygen, fentanyl, 100 micrograms/kg, and droperidol, 0.15 mg/kg, produced stable hemodynamics during induction, intubation, and sternotomy. Maintenance of pulmonary capillary wedge pressure by volume infusion may have been contributed to this stability.

UI MeSH Term Description Entries
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D011292 Premedication Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (ANTIBIOTIC PROPHYLAXIS) and anti-anxiety agents. It does not include PREANESTHETIC MEDICATION. Premedications
D004329 Droperidol A butyrophenone with general properties similar to those of HALOPERIDOL. It is used in conjunction with an opioid analgesic such as FENTANYL to maintain the patient in a calm state of neuroleptanalgesia with indifference to surroundings but still able to cooperate with the surgeon. It is also used as a premedicant, as an antiemetic, and for the control of agitation in acute psychoses. (From Martindale, The Extra Pharmacopoeia, 29th ed, p593) Dehydrobenzperidol,Dehidrobenzperidol,Droleptan,Inapsine
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
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000771 Anesthesia, Intravenous Process of administering an anesthetic through injection directly into the bloodstream. Anesthesias, Intravenous,Intravenous Anesthesia,Intravenous Anesthesias
D001026 Coronary Artery Bypass Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. Aortocoronary Bypass,Bypass, Coronary Artery,Bypass Surgery, Coronary Artery,Coronary Artery Bypass Grafting,Coronary Artery Bypass Surgery,Aortocoronary Bypasses,Artery Bypass, Coronary,Artery Bypasses, Coronary,Bypass, Aortocoronary,Bypasses, Aortocoronary,Bypasses, Coronary Artery,Coronary Artery Bypasses

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