CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by DE LANGE, S.
Right arrow Articles by ROBERTSON, D.
Right arrow Search for Related Content
PubMed
Right arrow Articles by DE LANGE, S.
Right arrow Articles by ROBERTSON, D.

Canadian Journal of Anesthesia, Vol 30, 248-254, Copyright © 1983 by Canadian Anesthesiologists' Society

Catecholamine and Cortisol Responses to Sufentanil-O2 and Alfentanil-O2 Anaesthesia during Coronary Artery Surgery

SIMON DE LANGE MB BS FFARCS1, THEODORE H. STANLEY MD1, MICHAEL J. BOSCOE MB BS FFARCS1, NORBERT DE BRUIJN MD1, LAWRENCE BERMAN MD1, ORVILLE GREEN MD1, and DAVID ROBERTSON MD1

1 Departments of Anesthesiology, The University Hospital of Leiden, the Netherlands, The University of Utah School of Medicine, Salt Lake City, Utah, Vanderbilt University Medical School, Nashville, Tennessee, Department of Medicine, Vanderbilt University Medical School, Nashville, Tennessee, Department of Pediatrics, Northwestern University, Evanston, Illinois

Address Correspondence to: Dr. Theodore H. Stanley, Department of Anesthesiology, The University of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, Utah 84132.

The effects of alfentanil-O2 and sufentanil-O2 anaesthesia on plasma catecholamines and cortisol were investigated in 32 patients undergoing coronary artery bypass grafting operations. After lorazepam-atropine premedication and pancuronium pretreatment, alfentanil was given to 16 patients at a rate of 3 mg·min-1 and sufentanil was given to 16 patients at 300 µg·min-1 until the patients were unconscious; at this time they were given succinylcholine and were intubated. After intubation an amount of alfentanil or sufentanil equal to the dose producing unconsciousness was infused over the next 30 min, at which time the operation began. Additional alfentanil or sufentanil were given whenever systolic arterial blood pressure increased more than 15 per cent of preanaesthetic values. Arterial blood samples were obtained for epinephrine, norepinephrine and cortisol assay and cardiovascular dynamics were recorded prior to anaesthetic induction, 5 min after tracheal intubation, immediately prior to and five min after incision, ten min after maximal sternal spread, just prior to beginning and after 30 and 60 min of bypass and at the end of operation. Cardiovascular dynamics were little changed throughout anaesthesia and operation. Plasma epinephrine and norepinephrine were not significantly changed until bypass. During bypass both hormones became increased and remained increased at the end of operation. Plasma cortisol decreased after incision and remained decreased until the end of operation. These data indicate that alfentanil-O2 and sufentanil-O2 anaesthesia produce similar changes in plasma catecholamines and cortisol as does fentanyl- O2 anaesthesia and hormonal effects are, therefore, not an explanation for any advantages the newer narcotics may have overfentanyl.

Key Words: ANALGESICS: sufentanil, alfentanil, fentanyl • ANAESTHESIA: cardiovascular • HORMONES: corticosteroid, catecholamine






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1983 by the Canadian Anesthesiologists' Society.