Abstract
Purpose: Due to the progressive aging of the surgical population, the proportion of patients with coronary artery disease (CAD) is likely to increase. The effects of the new inhalational anaesthetic sevoflurane must be determined in patients with known CAD. Methods: This multicentre, randomized, open-label study compared the haemodynamic and cardiovascular effects of sevoflurane and isoflurane with fentanyl in 284 ASA physical status II-IV patients undergoing elective coronary artery bypass graft (CABG). Results: Satisfactory records were available in 272 patients, 139 sevoflurane (Group S) and 133 isoflurane (Group I). There were no differences between groups for demographic data except that more patients in Group S were taking preoperative beta-blockers (P = 0.03). The mean end-tidal MAC and MAC · hr requirements between groups were not different (Group S received 0.63 ± 0.02 MAC and 1.00 ± 0.05 MAC · hr while Group I received 0.58 ± 0.02 MAC and 0.92 ± 0.05 MAC · hr P = NS). The preCPB use of intravenous fentanyl was not different between groups. There was a similar decrease in haemodynamic variables in both groups after induction that persisted throughout the preCPB period. The incidence of preCPB myocardial ischaemia, adverse haemodynamic events and use of vasoactive drugs did not differ between groups. The incidence of postoperative myocardial infarction was 2.2% for Group S and Group I was 4.5% (P = NS). There were five postoperative deaths, one of which was attributed to a cardiac cause (Group I). Conclusion: In patients undergoing elective CABG with low risk factors, either sevoflurane or isoflurane, combined with fentanyl, provided an acceptable preCPB haemodynamic profile and cardiac outcomes.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 890-899 |
| Number of pages | 10 |
| Journal | Canadian Journal of Anesthesia |
| Volume | 43 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 1996 |
Fingerprint
Keywords
- Anaesthesia: cardiac
- Anaesthetics, Intravenous: fentanyl
- Anaesthetics, Volatile: isoflurane, sevoflurane
- haemodynamics
- Heart: coronary artery disease
- Holter electrocardiography: pulse rate
- Monitoring: blood pressure
- myocardial ischaemia
- Surgery: coronary artery bypass graft
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Comparison of sevoflurane/fentanyl and isoflurane/fentanyl during elective coronary artery bypass surgery. / Searle, Norman R.; Martineau, Raymond J.; Conzen, Peter; Al-Hasani, A.; Mark, Lynette J; Ebert, Thomas; Muzi, Michael; Hodgins, Lewis R.
In: Canadian Journal of Anesthesia, Vol. 43, No. 9, 09.1996, p. 890-899.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of sevoflurane/fentanyl and isoflurane/fentanyl during elective coronary artery bypass surgery
AU - Searle, Norman R.
AU - Martineau, Raymond J.
AU - Conzen, Peter
AU - Al-Hasani, A.
AU - Mark, Lynette J
AU - Ebert, Thomas
AU - Muzi, Michael
AU - Hodgins, Lewis R.
PY - 1996/9
Y1 - 1996/9
N2 - Purpose: Due to the progressive aging of the surgical population, the proportion of patients with coronary artery disease (CAD) is likely to increase. The effects of the new inhalational anaesthetic sevoflurane must be determined in patients with known CAD. Methods: This multicentre, randomized, open-label study compared the haemodynamic and cardiovascular effects of sevoflurane and isoflurane with fentanyl in 284 ASA physical status II-IV patients undergoing elective coronary artery bypass graft (CABG). Results: Satisfactory records were available in 272 patients, 139 sevoflurane (Group S) and 133 isoflurane (Group I). There were no differences between groups for demographic data except that more patients in Group S were taking preoperative beta-blockers (P = 0.03). The mean end-tidal MAC and MAC · hr requirements between groups were not different (Group S received 0.63 ± 0.02 MAC and 1.00 ± 0.05 MAC · hr while Group I received 0.58 ± 0.02 MAC and 0.92 ± 0.05 MAC · hr P = NS). The preCPB use of intravenous fentanyl was not different between groups. There was a similar decrease in haemodynamic variables in both groups after induction that persisted throughout the preCPB period. The incidence of preCPB myocardial ischaemia, adverse haemodynamic events and use of vasoactive drugs did not differ between groups. The incidence of postoperative myocardial infarction was 2.2% for Group S and Group I was 4.5% (P = NS). There were five postoperative deaths, one of which was attributed to a cardiac cause (Group I). Conclusion: In patients undergoing elective CABG with low risk factors, either sevoflurane or isoflurane, combined with fentanyl, provided an acceptable preCPB haemodynamic profile and cardiac outcomes.
AB - Purpose: Due to the progressive aging of the surgical population, the proportion of patients with coronary artery disease (CAD) is likely to increase. The effects of the new inhalational anaesthetic sevoflurane must be determined in patients with known CAD. Methods: This multicentre, randomized, open-label study compared the haemodynamic and cardiovascular effects of sevoflurane and isoflurane with fentanyl in 284 ASA physical status II-IV patients undergoing elective coronary artery bypass graft (CABG). Results: Satisfactory records were available in 272 patients, 139 sevoflurane (Group S) and 133 isoflurane (Group I). There were no differences between groups for demographic data except that more patients in Group S were taking preoperative beta-blockers (P = 0.03). The mean end-tidal MAC and MAC · hr requirements between groups were not different (Group S received 0.63 ± 0.02 MAC and 1.00 ± 0.05 MAC · hr while Group I received 0.58 ± 0.02 MAC and 0.92 ± 0.05 MAC · hr P = NS). The preCPB use of intravenous fentanyl was not different between groups. There was a similar decrease in haemodynamic variables in both groups after induction that persisted throughout the preCPB period. The incidence of preCPB myocardial ischaemia, adverse haemodynamic events and use of vasoactive drugs did not differ between groups. The incidence of postoperative myocardial infarction was 2.2% for Group S and Group I was 4.5% (P = NS). There were five postoperative deaths, one of which was attributed to a cardiac cause (Group I). Conclusion: In patients undergoing elective CABG with low risk factors, either sevoflurane or isoflurane, combined with fentanyl, provided an acceptable preCPB haemodynamic profile and cardiac outcomes.
KW - Anaesthesia: cardiac
KW - Anaesthetics, Intravenous: fentanyl
KW - Anaesthetics, Volatile: isoflurane, sevoflurane
KW - haemodynamics
KW - Heart: coronary artery disease
KW - Holter electrocardiography: pulse rate
KW - Monitoring: blood pressure
KW - myocardial ischaemia
KW - Surgery: coronary artery bypass graft
UR - http://www.scopus.com/inward/record.url?scp=0029811540&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029811540&partnerID=8YFLogxK
U2 - 10.1007/BF03011801
DO - 10.1007/BF03011801
M3 - Article
C2 - 8874905
AN - SCOPUS:0029811540
VL - 43
SP - 890
EP - 899
JO - Canadian Journal of Anaesthesia
JF - Canadian Journal of Anaesthesia
SN - 0832-610X
IS - 9
ER -