We have located links that may give you full text access.
CLINICAL TRIAL
COMPARATIVE STUDY
JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL
Continuous infusions of alfentanil and propofol for coronary artery surgery.
OBJECTIVE: To study the anesthetic efficacy of two different background infusion rates for alfentanil in a total intravenous anesthesia (TIVA) technique using propofol. Therefore, the effects of these infusions on hemodynamic stability and on the suppression of hemodynamic and somatic responses to noxious stimuli were compared.
DESIGN: Prospective and randomized.
SETTING: The study was performed in a university hospital setting. Two patient groups were compared.
INTERVENTIONS: Anesthesia was induced in group 1 (n = 16) with alfentanil 50 micrograms/kg and in group 2 (n = 14) with alfentanil 75 micrograms/kg, infused in 4 min, as well as with an infusion of propofol at a rate of 10 mg/kg/h in both groups. After 4 min, the alfentanil infusion was reduced to 1 microgram/kg/min in group 1 and to 2 micrograms/kg/min in group 2. The propofol infusion was reduced following sternal spread to 3 mg/kg/h. Responses indicating inadequate anesthesia were treated with additional alfentanil bolus doses.
MEASUREMENTS AND MAIN RESULTS: Induction of anesthesia in group 1 was associated with significant decreases in systolic and diastolic (-13%) blood pressures, cardiac index (-16%) and left ventricular stroke work index (-31%). Hemodynamic changes were similar in group 2, except for the greater fall in systemic vascular resistance during maintenance of anesthesia. There was no difference in the incidence of breakthrough hypertension between the two groups (in 44% and 43% of the patients, respectively) and in the number of alfentanil bolus supplements. There were also no differences in the incidence of ischemia, myocardial infarction or duration of postoperative ventilation.
CONCLUSIONS: Because both infusions provided equally stable anesthesia, the lower infusion regimen for alfentanil is the more appropriate technique. Using this technique, the administration of additional alfentanil boluses just before stressful surgical episodes will further improve hemodynamic stability.
DESIGN: Prospective and randomized.
SETTING: The study was performed in a university hospital setting. Two patient groups were compared.
INTERVENTIONS: Anesthesia was induced in group 1 (n = 16) with alfentanil 50 micrograms/kg and in group 2 (n = 14) with alfentanil 75 micrograms/kg, infused in 4 min, as well as with an infusion of propofol at a rate of 10 mg/kg/h in both groups. After 4 min, the alfentanil infusion was reduced to 1 microgram/kg/min in group 1 and to 2 micrograms/kg/min in group 2. The propofol infusion was reduced following sternal spread to 3 mg/kg/h. Responses indicating inadequate anesthesia were treated with additional alfentanil bolus doses.
MEASUREMENTS AND MAIN RESULTS: Induction of anesthesia in group 1 was associated with significant decreases in systolic and diastolic (-13%) blood pressures, cardiac index (-16%) and left ventricular stroke work index (-31%). Hemodynamic changes were similar in group 2, except for the greater fall in systemic vascular resistance during maintenance of anesthesia. There was no difference in the incidence of breakthrough hypertension between the two groups (in 44% and 43% of the patients, respectively) and in the number of alfentanil bolus supplements. There were also no differences in the incidence of ischemia, myocardial infarction or duration of postoperative ventilation.
CONCLUSIONS: Because both infusions provided equally stable anesthesia, the lower infusion regimen for alfentanil is the more appropriate technique. Using this technique, the administration of additional alfentanil boluses just before stressful surgical episodes will further improve hemodynamic stability.
Full text links
Related Resources
Trending Papers
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Anti-Arrhythmic Effects of Heart Failure Guideline-Directed Medical Therapy and Their Role in the Prevention of Sudden Cardiac Death: From Beta-Blockers to Sodium-Glucose Cotransporter 2 Inhibitors and Beyond.Journal of Clinical Medicine 2024 Februrary 27
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app