Peyrin J C, Arvieux C, Girardet P, Fargnoli J M, Stieglitz P
Anesth Analg (Paris). 1981;38(11-12):627-31.
A retrospective study of the anaesthetic records in cardiac surgical patients was undertaken: massive doses of fentanyl were used according to Stanley (29). The rate of drug administration was fentanyl 150 micrograms/kg for induction and 15 to 25 micrograms/kg/hour for maintenance, pancuronium bromide 0,1 mg/kg for induction and 0,015 mg/kg/hour for maintenance. Myocardial oxygen consumption (estimated by rate-pressure-product) during induction period remains constant. The oesophago-rectal temperature gradient is smaller than with other anaesthetic techniques, showing a very good perfusion homogeneity without the need of vasodilatator drugs. The temperature after-drop in the post bypass period is also reduced (less than 1,2 degrees C). The incidence of hemodynamic and rhythmic disturbances during operations and during the first post-operative day is lowered. Delayed respiratory autonomy appears to be the major drawback of this method (group 1: 25,30 h +/- 7,30 h; 30,20 h +/- 12,25 h; group 3: 21,15 h +/- 6,25 h).
根据斯坦利(29)的方法使用了大剂量芬太尼。给药速率为诱导期芬太尼150微克/千克,维持期15至25微克/千克/小时,诱导期潘库溴铵0.1毫克/千克,维持期0.015毫克/千克/小时。诱导期心肌耗氧量(通过心率-血压乘积估算)保持恒定。食管-直肠温度梯度比其他麻醉技术小,显示出非常好的灌注均匀性,无需血管扩张药物。体外循环后体温下降也减少(小于1.2摄氏度)。手术期间和术后第一天血流动力学和节律紊乱的发生率降低。延迟恢复呼吸自主似乎是这种方法的主要缺点(第1组:25.30小时±7.30小时;30.20小时±12.25小时;第3组:21.15小时±6.25小时)。