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Sufentanil-midazolam anesthesia for coronary artery surgery
K J Tuman1, R J McCarthy, A R el-Ganzouri
1Department of Anesthesiology, Rush Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
Journal of Cardiothoracic Anesthesia
|June 1, 1990
Summary
Low-dose sufentanil and midazolam anesthesia is safe for coronary artery surgery, maintaining stable hemodynamics and avoiding hypotension associated with high-dose narcotics and benzodiazepines.
Area of Science:
- Anesthesiology
- Cardiovascular Surgery
Background:
- High-dose narcotics combined with benzodiazepines can cause hypotension during coronary artery surgery.
- Previous studies indicate potential cardiovascular risks with combined anesthetic agents.
Purpose of the Study:
- To evaluate the cardiovascular effects of low-dose sufentanil and midazolam in patients undergoing coronary artery surgery.
- To determine the safety and hemodynamic stability of this anesthetic combination.
Main Methods:
- Thirty adult patients undergoing elective coronary revascularization received low-dose sufentanil and midazolam.
- Hemodynamic parameters were monitored before, during, and after cardiopulmonary bypass (CPB).
- Patients were stratified based on preoperative beta-adrenergic blockade status.
Main Results:
- Stable hemodynamics were achieved throughout the procedure in all patients.
- No significant hypotension or clinically significant increases in heart rate or rate-pressure product were observed.
- Hypertension occurred in five patients but was manageable; beta-blocker use mitigated this risk.
- Ischemic electrocardiographic changes were infrequent and not significantly different between groups.
Conclusions:
- Low-dose sufentanil and midazolam provide a hemodynamically safe and stable anesthetic for coronary artery surgery.
- This combination avoids the hypotension associated with high-dose narcotic and benzodiazepine regimens.
- Preoperative beta-blockade may offer additional cardiovascular protection during this anesthetic approach.