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Fentanyl oxygen anaesthesia for abdominal aortic surgery.
Canadian Anaesthetists' Society Journal
|November 1, 1986
Summary
High-dose fentanyl anesthesia (100 mcg/kg) for abdominal aortic surgery did not prevent hyperdynamic responses. Many patients required interventions for hypertension and experienced myocardial ischemia, indicating inadequate hemodynamic control.
Area of Science:
- Anesthesiology
- Cardiovascular Surgery
- Pharmacology
Background:
- Abdominal aortic surgery patients often have concurrent coronary artery disease.
- Fentanyl is commonly used for anesthesia in these procedures.
- Maintaining hemodynamic stability is crucial during major vascular surgery.
Purpose of the Study:
- To evaluate hemodynamic responses during fentanyl-oxygen anesthesia in abdominal aortic surgery.
- To assess the efficacy of a high-dose fentanyl regimen (100 mcg/kg) in controlling circulatory dynamics.
- To identify the incidence of perioperative hypertension, myocardial ischemia, and need for interventions.
Main Methods:
- 16 patients undergoing abdominal aortic surgery received fentanyl (100 mcg/kg) for anesthesia induction.
- Hemodynamic parameters were monitored throughout the procedure.
- Interventions for hyperdynamic responses, hypertension, and ischemia were recorded.
Main Results:
- 13 out of 16 patients exhibited hyperdynamic circulatory responses requiring treatment before aortic cross-clamping.
- 11 patients needed treatment for postoperative hypertension.
- 5 patients developed myocardial ischemia (ST depression > 0.1 mV).
Conclusions:
- Unsupplemented high-dose fentanyl anesthesia (100 mcg/kg) is insufficient to maintain a hypodynamic state in patients undergoing abdominal aortic surgery.
- Significant interventions are often required to manage hemodynamic instability and prevent ischemic events.
- Alternative anesthetic strategies or adjuncts may be necessary for optimal patient management.