Document Detail


Myocardial metabolism and haemodynamic responses during high-dose fentanyl anaesthesia for coronary patients.
MedLine Citation:
PMID:  6333915     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fentanyl (mean dose 109 micrograms X kg-1) and oxygen were given to ten patients having coronary vein grafts. Serial studies were done before, during and after operation, of central and mean arterial pressures (MAP), cardiac index (CI) and coronary sinus flow (CBF) by thermodilution, myocardial oxygen consumption (MVO2) and lactate extraction (MLE). On induction CI and stroke work index decreased, but heart rate and MAP were unchanged as systemic resistance increased. Mean MAP and heart rate remained at the awake levels. Mean CBF remained unchanged along with stable MAP and coronary resistance. Oxygen content of CS blood increased on induction and remained elevated until the incision; it was above the awake level early postoperatively. MVO2 was low normal when the patients were awake and remained so. Normal MLE continued with a few exceptions. High-dose fentanyl did not uniformly abolish autonomic reflexes. Heavy premedication, complete beta adrenergic blockade and a high initial doses of fentanyl plus its continued infusion, aided in retaining a hypodynamic circulation and myocardial oxygenation.
Authors:
E A Moffit; J E Scovil; R A Barker; A E Marble; J A Sullivan; C DelCampo; C L Cousins; C E Kinley
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian Anaesthetists' Society journal     Volume:  31     ISSN:  0008-2856     ISO Abbreviation:  Can Anaesth Soc J     Publication Date:  1984 Nov 
Date Detail:
Created Date:  1985-01-14     Completed Date:  1985-01-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0371163     Medline TA:  Can Anaesth Soc J     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  611-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Inhalation*
Blood Pressure / drug effects
Cardiac Output / drug effects
Coronary Artery Bypass*
Coronary Circulation / drug effects
Female
Fentanyl / pharmacology*
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Lactates / metabolism
Lactic Acid
Male
Middle Aged
Myocardium / metabolism*
Preanesthetic Medication
Pulmonary Circulation / drug effects
Time Factors
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Lactates; 437-38-7/Fentanyl; 50-21-5/Lactic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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