Document Detail

Dissociation of mixed venous oxygen saturation and cardiac index during opioid induction.
MedLine Citation:
PMID:  7911309     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To evaluate the independent effects of opioid induction and paralysis on changes in mixed venous oxygen saturation (SvO2). DESIGN: Prospective, with each patient serving as his or her own control. SETTING: Cardiac operating rooms of a major U.S. teaching hospital. PATIENTS: 15 elective patients for aortocoronary bypass graft surgery. INTERVENTIONS: Prior to induction with sufentanil 2 to 3 micrograms/kg (t1), after recovery from succinylcholine 1 to 1.5 mg/kg (t2), and after subsequent paralysis with vecuronium (t3), we recorded cardiac index (VO2), arterial oxygen saturation (SaO2), and SvO2, then calculated oxygen consumption (VO2) and arterial oxygen content (CaO2). MEASUREMENTS AND MAIN RESULTS: SvO2 increased from 75% at t1 to 82% at t2 (p = 0.03) and to 83% at t3 (p = 0.006). CI decreased from 3.1 L/min/m2 at t1 to 2.5 L/min/m2 at t2 (p = 0.023) and to 2.1 L/min/m2 at t3 (t1 vs. t3, p = 0.019; t2 vs. t3, p = NS). Calculated VO2 decreased from 2.88 ml O2/min/kg at t1 to 2.09 ml O2/min/kg at t2 (p = 0.03) and to 1.87 ml O2/min/kg at t3 (t1 vs. t3, p = 0.002; t2 vs. t3, p = 0.027). CaO2 remained unchanged. CONCLUSIONS: Opioid anesthesia, not paralysis, increases SvO2. Most of the decrease in VO2 occurs from anesthesia, not paralysis. The direct relationship between CI and SvO2 no longer holds upon induction of anesthesia. Parallel changes in CI cannot be inferred based on SvO2 alone.
P Colonna-Romano; J C Horrow
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  6     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:    1994 Mar-Apr
Date Detail:
Created Date:  1994-07-14     Completed Date:  1994-07-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  95-8     Citation Subset:  IM    
Department of Anesthesiology, Hahnemann University, Philadelphia, PA 19102-1192.
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MeSH Terms
Anesthesia, Intravenous*
Cardiac Output / drug effects,  physiology*
Coronary Artery Bypass*
Hemoglobins / analysis
Hydrogen-Ion Concentration
Oxygen / blood*
Oxygen Consumption / drug effects,  physiology
Prospective Studies
Succinylcholine* / pharmacology
Sufentanil* / pharmacology
Vecuronium Bromide* / pharmacology
Reg. No./Substance:
0/Hemoglobins; 306-40-1/Succinylcholine; 50700-72-6/Vecuronium Bromide; 56030-54-7/Sufentanil; 7782-44-7/Oxygen

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