Abstract
We measured the dose of sufentanil required for unconsciousness as well as the entire operation in 44 patients (22 taking Propranolol and 22 not taking Propranolol) undergoing coronary artery bypass grafting (CABG) operations. The incidence of hypertension during Operation, requirements for supplements to treat hypertension and recovery times were also determined. The data indicate that patients undergoing CABG operations taking propranolol require significantly less sufentanil for unconsciousness and the entire operation than patients not taking this drug. In spite of requiring less sufentanil, patients taking Propranolol had less hypertension during operation and thus required less supplements. However recovery times in both groups were the same.
The results of this study may partially explain the varying incidence of hypertension reported during high dose fentanyl and other narcotic-oxygen anaesthetic techniques.
Résumé
Cette étude a été effectuée chez 44 malades ayant subi un pontage aorto-coronarien. Vingt deux des patients avaient reçu du Propranolol avant l’intervention, les vingt-deux autres n’en avaient pas reçu. Nous avons noté, dans chacun des cas, les doses de sufentanil nécessaires à la production de l’inconscience ainsi que les doses totales de cet agent requises au cours de l’intervention. Nous avons également noté tous les cas d’hypertension per-opératoire, les interventions médicamenteuses requises au traitement de l’hypertension et le temps d’éveil après l’intervention.
Les doses de sufentanil produisant l’inconscience ainsi que les doses totales de cet agent requises en cours d’intervention étaient significativement moindres chez les patients qui avaient reçu du Propranolol avant leur intervention que chez ceux qui n’en avaient pas reçu. Même avec des doses de sufentanil inférieures, les patients qui avaient reçu du Propranolol ont présenté moins d’hypertension per-opératoire et ont requis moins d’interventions médicamenteuses pour traiter cette complication. Les temps d’éveil après l’intervention ont été les mêmes chez les patients des deux groupes.
Les résultats de ce travail peuvent expliquer partiellement l’incidence variable d’hypertension rapportée au cours d’anesthésie au fentanil à haute dose ou avec d’autres techniques à base d’analgésiques et d’oxygène.
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de Castro, J., Van de Water, A., Wouters, L., Xhonneux, R., Reneman, R. &Kay, B. Comparative study of cardiovascular, neurological and metabolic side effects of eight narcotics in dogs. Acta. Anesthesiolog. Belg.36: 5 (1979).
de Castro, J. Practical applications and limitation of analgesic anaesthesia. Acta. Anesthesiolog. Belg. 27–107 (1976).
de Lange, S., Stanley, T.H. &Boscoe, M.J. Comparison of sufentanil-O2 and fentanyl-O2 anaesthesia for coronary artery surgery. Anesthesiology56: 112 (1982).
Stanley, T.H., Leysen, J. &Niemegers, C. The influence of diazepam and droperidol on CNS receptor binding. Anesthesiology53: S33 (1980).
Hug, C.C., Jr. Pharmacokinetics of drugs administered intravenously. Anesth. Analg.57: 704 (1978).
Waller, J., Hug, C., Nagle, D.M. &Craver, J.M. Hemodynamic changes during fentanyl-oxygen anaesthesia for aortocoronary bypass operation. Anesthesiology55: 212 (1981).
Stanley, TH., Philbin, D.M. &Coggins, C.H. Fentanyl-oxygen anaesthesia for coronary artery surgery. Cardiovascular and anti-diuretic hormone responses. Can. Anaesth. Soc. J.26: 168 (1979).
Bovill, J.G. &Sebel, P.S. Pharmacokinetics of high-dose fentanyl. A study in patients undergoing cardiac surgery. Br. J. Anaesth.52: 795 (1980).
Wynands, J.E. Anesthetic considerations for coronary artery surgery. Cleve. Clin. Quart.48: 86 (1981).
Hilgenberg, J.C. Intraoperative awareness during high-dose fentanyl-oxygen anaesthesia. Anesthesiology54: 341 (1981).
Kopriva, C.J., Brown, A.C.D. &Pappas G. Hemodynamics during general anesthesia in patients receiving Propranolol. Anesthesiology48: 28 (1978).
de Lange, S., Stanley, LH. &Boscoe, M. J. Alfentanyl-oxygen, anaesthesia for coronary artery surgery. Br. J. Anaesth.53: 1291 (1981).
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This work has been supported in part by Stanley Research Foundation.
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Stanley, T.H., de Lange, S., Boscoe, M.J. et al. The influence of chronic preoperative propranolol therapy on cardiovascular dynamics and narcotic requirements during operation in patients with coronary artery disease. Can. Anaesth. Soc. J. 29, 319–324 (1982). https://doi.org/10.1007/BF03007519
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DOI: https://doi.org/10.1007/BF03007519