[Choice of agents for early activation-oriented general anesthesia in patients operated on for ischemic heart disease].

The purpose of the study was to analyze the choice of agents for general anesthesia in the implementation of an early activation in patients operated on for coronary heart disease (CHD). Anesthetic maintenance protocols were analyzed in 1008 patients who were operated on under extracorporeal circulation (EC) in 1995, 1999, 2001, 2004, and 2006. After aortocoronary bypass grafting, the trachea was extubated in 45% of cases. 1999 was marked by a significant diference in the use of agents for general anesthesia in patients activated in the operating suite and in those who had prolonged artificial ventilation. In 2006, there were differences in the frequency of use of anesthetics in activated and inactivated patients. In 2006, the most popular anesthetics were propofol (82% of cases), midazolam (72%), isoflurane (37%), and sevoflurane (53%). The doses of fentanyl were reduced from 10.3 +/- 0.3 microg/kg/h in 1995 to 3.4 +/- 0.2 microkg/kg/h in 2006 (p < 0.05). During activation in the operating room, the frequency of naloxone use was reduced from 85.2% in 1999 to 21.1% in 2006 (p < 0.05). The authors paid particular attention to the pharmacodynamics of anesthetics used for the early activation of patients operated on under EC for CHD. It is concluded that early activation of patients operated on under EC for CHD is possible after general anesthesia based on diferent agents. Early activation substantially changes the concept of general anesthesia during myocardial revascularization operations.