Mathews H M, Furness G, Carson I W, Orr I A, Lyons S M, Clarke R S
Department of Anaesthetics, Queen's University of Belfast.
Br J Anaesth. 1988 Apr;60(5):530-5. doi: 10.1093/bja/60.5.530.
Haemodynamic variables were compared in 40 adults undergoing coronary artery bypass grafting during anaesthesia induced with either sufentanil 5 micrograms kg-1 or fentanyl 25 micrograms kg-1 in combination with pancuronium 0.1 mg kg-1. Further doses of sufentanil 2.5 micrograms kg-1 or fentanyl 12.5 micrograms kg-1 were given before skin incision and again before sternotomy. All patients were receiving beta-adrenoceptor blocking therapy. Satisfactory induction of anaesthesia was produced with both drugs and opioid supplementation prevented any marked haemodynamic response to skin incision and to sternotomy. Following induction of anaesthesia, sufentanil produced the greater decrease in mean arterial pressure and left ventricular stroke work index which continued throughout the study. This suggests that, in the doses used in this study, sufentanil is preferable to fentanyl in patients with coronary artery disease.
对40名接受冠状动脉搭桥术的成年人进行了血流动力学变量比较,这些患者在麻醉诱导时分别使用5微克/千克舒芬太尼或25微克/千克芬太尼,并联合使用0.1毫克/千克潘库溴铵。在皮肤切开前和胸骨切开前,再分别给予2.5微克/千克舒芬太尼或12.5微克/千克芬太尼。所有患者均接受β肾上腺素能受体阻滞剂治疗。两种药物均产生了满意的麻醉诱导效果,补充阿片类药物可防止对皮肤切开和胸骨切开产生任何明显的血流动力学反应。麻醉诱导后,舒芬太尼使平均动脉压和左心室每搏功指数下降幅度更大,且在整个研究过程中持续存在。这表明,在本研究使用的剂量下,对于冠心病患者,舒芬太尼比芬太尼更可取。