| Abstract: | In a prospective randomized study of 48 patients scheduled to undergo elective coronary artery surgery, sufentanil (20 micrograms/kg) was compared with fentanyl (100 micrograms/kg) anesthesia by assessing hemodynamic and plasma catecholamine level responses to surgery. At 15 points during the study, cardiovascular dynamics were recorded. At six points in the study, arterial blood was obtained for simultaneous assays of plasma concentrations of epinephrine, norepinephrine, and dopamine. Neither mean cardiovascular dynamics nor catecholamine concentrations were statistically significantly different between the groups preoperatively. Both agents provided generally stable hemodynamics during surgery. Sufentanil was associated with decreased systemic vascular resistance at several time points with concurrent increased cardiac index and heart rate. Although catecholamine levels increased somewhat during cardiopulmonary bypass in both groups, there were no significant differences between the groups at any point except that at chest closure patients given sufentanil had significantly lower dopamine concentrations than those given fentanyl. Times for recovery from surgery failed to show any difference between the two groups of patients. Blood pressure increases with patients given sufentanil compared favorably with those given fentanyl. We conclude that at these doses, with this surgery, there were no major clinical differences, though sufentanil produced significantly lower systemic vascular resistance at several events and had a lower plasma dopamine concentration after cardiopulmonary bypass. |
