RESUMO
In a randomized study of 16 pediatric patients undergone open-heart surgery, the postoperative recovery time and ventilatory support time of the patients anesthetized with fentany (fentanyl group, n=8) was compared with those of the patients anesthetized with morphine (morphine group, n=8). All patients were premedicated with 0.1 mg/kg of morphine and 0.008mg/kg of glycoppyrolate i.m. 1hr prior to anesthesia. In morphine group, anesthesia was induced with morphine 0.5mg/kg and thiopental 3 mg/kg and in fentanyl group with fentanyl 5 ug/kg and thiopental 3 mg/kg. Anesthesia was maintained with assigned opiate based upon cardiovascular signs. The total doses of opiates are 3.2mg/kg in morphine group and 34.3pg/kg in fentanyl group. In fentanyl group the time to regain consciousness (107+/-53min), ventilatory support time (209+/-53min) and the time from end of operation to extubation (589+/-82min) are significantly shorter than in morphine group (142+/-41min, 838+/-220min, 1470+/-269min, respectively). From the above results fentanyl is more suitable i.v. anesthetic agent for open-heart surgry in respect of postoperative ventilatory care.
Assuntos
Humanos , Anestesia , Estado de Consciência , Fentanila , Coração , Morfina , TiopentalRESUMO
Autonomic hyperreflexia is a syndrome of massive reflex sympathetic discharge that occurs in patients with chronic spinal cord lesions above the major sympathetic splanchnic outflow (T 4 -T6). We experienced autonomic hyperreflexia that occured in a patient with spinal cord trans-section at T5 level during general anesthesia with O2-N2O-halothane. Hypertension was controlled with intravenous infusion of sodium nitroprusside (1-2 ug/kg/min) and ventricular arrhythmia was treated with intra- venous lidocaine. We recommend that direct acting vasodilators are useful drugs to control hypertension in autonomic hyperreflexia during anesthesia in patients with chronic spinal cord injury.