| Effects of Fentanyl - Oxygen Anesthesia on Serum Catecholamine during Open Heart Surgery. |
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Chong Sung Kim, Jae Hyon Bahk, Sang Tae Kim, Yong Chul Kim, Kwang Woo Kim |
1Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.
2Department of Anesthesiology, Central Army Force Hospital, Seoul, Korea. |
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| Abstract |
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Serum epinephrine and norepinephrine concentrations were measured in 7 patients during fentanyl-oxygen anesthesia, who were undergoing elective open heart surgery(single valvular replacement operations) in Seoul National University Hospital. Sampling times and corresponding total fentanyl doses were as follows; 1) after arterial cannulation 2) 5 minutes after intubation(50 ug/kg of B. Wt) 3) 5 minutes after sternotomy(65 ug/ka) 4) after aortic dissection(75 ug/kg) 5) 15 minutes after initiating bypass 6) 60 minutes after initiating bypass [20 ug/kg of fentanyl was added to the priming solution before initiation of Cardio-pulmonary bypass(CP bypass)]. High Performance Liquid Chromatography(HPLC) was used to analyze hormones.
Epinephrine concentrations(pg/ml) corresponding to the sampling times were as follows (mean+/-SE); 1) 213+/-59 2) 199+/-62 3) 246+/-83 4) 173+/-35 5) 270+/-70 6) 269+/-70 Norepinephrine concentrations(pg/ml) were as follows(mean+/-SE); 1) 609+/-107 2) 500+/-73 3) 645+/-152 4) 470+/-82 5) 494+/-65 6) 955+/-311 There were no significant hormonal changes except the 6th norepinephrine value. There were no significant hemodynamic changes except blood pressure decrease at the beginning of CP bypass. It is concluded that high dose fentanyl-oxygen anesthesia was limitedly effective to block the stress of open heart surgery, general anesthesia and CP bypass. |
| Key Words:
Anesthesia; Fentanyl; Open heart surgery; Norepinephrine; Epinephrine |
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