[Fentanyl-oxygen-pancuronium anaesthesia in cardiac surgery (author's transl)]. / Anesthésie au fentanyl-oxygène-pancuronium en chirurgie cardiaque.

ABSTRACT

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).