Continuous Infusion Of Fentanyl Or Alfentanil For Coronary-Artery Surgery - Plasma Opiate Concentrations, Hemodynamics And Postoperative Course

Nine patients received a mean total dose of 110 micrograms kg-1 of fentanyl and 10 patients received alfentanil 1379 micrograms kg-1 as a continuous infusion during coronary artery bypass grafting (CABG). Circulatory stability was well maintained through the induction of anaesthesia and a similar cardiovascular course was achieved with both agents, with the exception of small differences in heart rate and cardiac index immediately before tracheal intubation. Similar haemodynamic responses to sternotomy, cardiopulmonary bypass and awakening from anaesthesia were found with both analgesics. Although the times to awakening and extubation were somewhat shorter in patients receiving alfentanil, the differences between the groups were not significant. With the continuous infusion techniques, plasma opiate concentrations could be maintained well above the awakening values during cardiopulmonary bypass. In a total dose ratio of 1:13, fentanyl and alfentanil produced similar haemodynamic profiles and clinical courses in patients undergoing CABG.