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Related Experiment Videos

Changes in ejection fraction during induction of anesthesia with two different i.v. techniques.

G Dahlgren1, L A Brodin, G Ohqvist

  • 1Department of Anesthesia, Karolinska Hospital, Stockholm, Sweden.

Acta Anaesthesiologica Scandinavica
|November 1, 1988
PubMed
Summary

Anesthesia induction with fentanyl alone preserved ejection fraction (EF) and central hemodynamics in cardiac surgery patients. Combining diazepam, thiopentone, and fentanyl significantly reduced EF and altered hemodynamics during intubation.

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Area of Science:

  • Anesthesiology
  • Cardiovascular Physiology

Background:

  • Coronary artery surgery requires careful anesthetic management to maintain cardiac function.
  • Intravenous anesthetic induction agents can impact myocardial performance and hemodynamics.

Purpose of the Study:

  • To compare the effects of two intravenous anesthetic induction techniques on left ventricular ejection fraction (EF) and central hemodynamics in patients undergoing coronary artery surgery.

Main Methods:

  • Thirty patients were divided into two groups: Group I (diazepam, thiopentone, fentanyl) and Group II (fentanyl alone).
  • Left ventricular EF was measured using radionuclide ventriculography (Tc 99 m HSA).
  • Stroke volume index (SI) and systemic vascular resistance index (SVRI) were determined by thermodilution and other methods.

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Main Results:

  • Group I showed a significant decrease in EF (0.43 to 0.26) and increased SVRI at intubation.
  • Left ventricular volumes decreased in Group I during induction, except at intubation.
  • Group II maintained stable EF, left ventricular volumes, and SVRI throughout induction.

Conclusions:

  • Fentanyl alone as an induction agent is hemodynamically stable for patients undergoing coronary artery surgery.
  • Combined anesthetic induction with diazepam, thiopentone, and fentanyl adversely affects left ventricular function and hemodynamics during intubation.