[Anesthesia in aortocoronary bypass surgery: comparison of effects on hemodynamics of recent technics of total intravenous anesthesia].

20 patients electively scheduled for operation were enrolled in the study and anaesthetized randomly with one of the two techniques etomidate + fentanyl (I) or flunitrazepam + fentanyl (II). Haemodynamics were assessed by continuously measuring blood pressure in the systemic and pulmonary circulations, as well as the heart rate, and intermittently determining the cardiac output. It could be shown that systemic arterial blood pressure, in spite of an initial drop after induction of anaesthesia, remained within an acceptable safety margin throughout the investigation period. Whereas heart rate remained almost constant in both groups, the rate-pressure product which may serve as a measure of myocardial oxygen consumption in the clinical setting, decreased considerably in both groups, although more appreciably under the influence of the anaesthetic technique flunitrazepam + fentanyl. Although the diastolic blood pressure as the most significant individual factor determining coronary blood flow was not changed appreciably in both groups, it remained at a higher level under the influence of the anaesthetic technique etomidate + fentanyl (I). We conclude that both anaesthetic regimes described here may be safely applied for the anaesthesia of patients with reduced coronary perfusion and cardio-haemodynamic reserve potential.