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    Comparison of effects of sevoflurane and high-dose fentanyl anesthesia on hemodynamic profile and postoperative recovery in coronary artery surgery
    (2005) Yorulmaz V.; Arar C.; Turan N.; Pamukçu Z.
    Aim: Hemodynamic and recovery characteristics of two anesthetic techniques were compared in patients undergoing CABG. Materials and Methods: After the approval of Ethics Committee, 55 patients were randomized in: Group I (n=28) to receive intravenous diazepam 0.2 me kg-1, pancuronium 0.1 mg kg -1 and fentanyl 10 ?g kg-1, and Group II (n=27) to receive diazepam 0.2 mg kg-1, pancuronium 0.1 mg kg-1 and fentanyl 50 ?g kg-1 for induction. Anesthesia was maintained with 2 % end-tidal sevoflurane and fentanyl 5 ?g kg-1 in Group I; with fentanyl 15 ?g kg-1 in Group II. Hemodynamic measurements were recorded before and after induction and intubation, after incision and sternotomy, before aortic cannulation, 15 minutes after removal from pump, at the end of surgery, at 2nd hour postoperatively. Time of spontaneous eye opening, orientation, extubation and the length of intensive care unit stay were recorded as recovery criteria. Results: In Group I heart rate increased after intubation, left ventricle stroke work and index decreased at all measurements (p<0.05). In Group II mean arterial pressure decreased after sternotomy and before aortic cannulation; was higher than Group; cardiac output and index were higher at all measurements except after incision; left ventricle stroke volume was lower at all measurements except after strenotomy and 2 nd hour postoperatively (p<0.05). Arterial blood gas analyses, blood, fresh frozen plasma or drug consumptions and length of intensive care unit stay were similar, recovery were shorter in Group I (p<0.001). Conclusion: As a result, sevoflurane-low-dose fentanyl anesthesia provided hemodynamic stability similar to high-dose fentanyl anesthesia in patients undergoing CABG, moreover, with earlier recovery, sevofluranelow dose fentanyl may be an alternative to high-dose fentanyl anesthesia.