Cardiovascular effects of alfentanil anaesthesia

In 30 patients undergoing cardiac surgery, anaesthesia was induced with alfentanil 125 micrograms kg-1 and maintained with an infusion of alfentanil 0.5 mg kg-1 h-1 until the start of cardiopulmonary bypass, and alfentanil 0.25 mg kg-1 h-1 thereafter until the end of surgery. Pancuronium was given and the lungs ventilated with air in oxygen. In the majority of patients, there were no significant changes in cardiovascular measurements throughout the study, although two received sodium nitroprusside for the control of hypertension, and in one patient hypertension was so severe that the method of anaesthesia was abandoned. Transient hypotension occurred on induction in one patient. Twenty-six patients required alfentanil supplementation before bypass. These results indicate that anaesthesia with an alfentanil infusion provides satisfactory cardiovascular stability for cardiac surgery.