A comparison of the haemodynamic effects of propofol ('Diprivan') and thiopentone in patients with coronary artery disease.

Twenty patients scheduled for elective coronary surgery received either propofol ('Diprivan') 1.5 mg/kg in emulsion or thiopentone 2 mg/kg for induction of anaesthesia. Vecuronium was used for neuromuscular blockade. Cardiovascular dynamics were recorded every minute until 6 min after intubation. Anaesthesia with propofol was accompanied by a reduction in arterial pressure, the decrease being severe in two patients. This was largely due to a decrease in systemic vascular resistance. Thiopentone anaesthesia resulted in a smaller decrease in arterial pressure, but a marked increase in arterial pressure followed endotracheal intubation. Although the absence of haemodynamic changes following intubation during propofol anaesthesia is advantageous to the ischaemic myocardium, this has to be balanced by the variable and sometimes severe reduction in arterial pressure that occurred on induction.