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 MOFFIT, E. A.
Right arrow Articles by KINLEY, C. E.
Right arrow Search for Related Content
PubMed
Right arrow Articles by MOFFIT, E. A.
Right arrow Articles by KINLEY, C. E.

Canadian Journal of Anesthesia, Vol 31, 611-618, Copyright © 1984 by Canadian Anesthesiologists' Society

Myocardial Metabolism and Haemodynamic Responses during High-Dose Fentanyl Anaesthesia for Coronary Patients

EMERSON A. MOFFIT MD1, JOHN E. SCOVIL MD1, RICHARD A. BARKER MB1, ALLEN E. MARBLE PHD1, JOHN A. SULLIVAN MD1, CARLOS DELCAMPO MD1, CHARMAN L. COUSINS PHD1, and C. EDWIN KINLEY MD1

1 Departments of Anaesthesia, Pathology and Surgery, Dalhousie University and the Maritime Heart Centre, Victoria General Hospital, Halifax, Nova Scotia

Address correspondence to: Dr. E.A. Moffitt, Sir Charles Tupper Medical Building, University Avenue, Halifax, Nova Scotia, B3H 4H7.

Fentanyl (mean dose 109 µg·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.

Key Words: HEART: oxygen consumption • ANAESTHESIA: cardiovascular • ANAESTHETICS, INTRAVENOUS: fentanyl • SURGERY: cardiovascular






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1984 by the Canadian Anesthesiologists' Society.