Effects of different doses of sufentanil combined with low target plasma concentration of propofol for induction of anesthesia on hemodynamics in patients undergoing coronary artery bypass grafting: determination using Swan-Ganz catheter / 中华麻醉学杂志

ABSTRACT

Objective To evalutate the effects of different doses of sufentanil combined with low target plasma concentration of propofol for induction of anesthesia on hemodynamics in patients undergoing coronary artery bypass grafting using Swan-Ganz catheter.Methods Fifty ASA physical status Ⅱ-Ⅲ patients (NYHA Ⅱ or Ⅲ) patients,aged 45-64 yr,with body mass index ≤ 30 kg/m2 and left ventricular ejection fraction (LVEF) ≥ 50 ％,scheduled for elective coronary artery bypass grafting,were randomly assigned into 2 groups (n =25 each) using a random number tablesufentanil 0.5μg/kg group (group S1) and sufentanil 1.0 μg/kg group (group S2).Central venous catheter and Swan-Ganz catheter were all placed via the right jugular vein before induction of anesthesia.Anesthesia was induced with iv injection of sufentanil 0.5 μg/kg (group S1) or 1.0 μg/kg (group S1),and 60 s later propofol was given by target-controlled infusion (target plasma concentraion 2 μg/ml).Rocuronium 0.8 mg/kg was administered when consciousness was lost.The patients were endotracheally intubated and mechanically ventilated.Before induction (T1),immediately after loss of consciousness (T2),immediately before intubation (T3),and immediately after intubation (T4),HR,mean artery pressure monitoring (MAP),central venous pressure (CVP),pulmonary arterial wedge pressure (PAWP),cardiac index (CI),stroke volume index (SVI),systolic vascular resistance and mixed venous oxygen saturation (Sv-O2) were recorded.The development of adverse cardiovascular events was recorded during induction of anesthesia.Results Compared with the baseline value at T1,the MAP and systolic vascular resistance were significantly decreased at T3 in group S2 (P ＜ 0.05),and no significant changes were found in the parameters of hemodynamics at T2-4 in group S1 (P ＞ 0.05).Compared with group S1,the MAP was significantly decreased at T3 and the incidence of hypotension was increased in group S2 (P ＜ 0.05).Conclusion For the patients undergoing coronary artery bypass grafting,the optimum dose of sufentanil for induction of anesthesia is 0.5 μg/kg when combined with low target plasma concentration of propofol.