Clinical evaluation of sufentanil/pancuronium versus halothane/pancuronium in patients undergoing coronary artery surgery1
The authors prospectively studied 29 patients undergoing coronary artery surgery, with normal or mildly impaired ventricular function. Seventeen patients received sufentanil (15 to 20 μg/kg) and 100% O2 (group 1); 12 received sodium thiopental/halothane (1% to 3%), 50% O2, and 50% N2O (group 2). Hemodynamic parameters were measured before induction (control levels), and at three-minute intervals after intubation, incision, sternotomy, and immediately before cannulation of the great vessels. In both groups, the heart rate increased from control levels during induction and remained increased at all measurements (P < 0.01). Nine patients in group 1, and 4 in group 2 required beta blockers to control tachycardia. The cardiac index was higher than the control level at three points in group 1 (P < 0.01); and lower at one point (P < 0.01) in group 2. Pulmonary capillary wedge pressure did not change from the control level in group 1, but increased at two points (P < 0.05) in group 2. Recovery time and time to extubation were significantly longer in the sufentanil group (P < 0.01), which was probably due to the large dose. Sufentanil provided adequate surgical anesthesia, without patient recall of intraoperative events. Unlike halothane, sufentanil did not cause myocardial depression. However, sufentanil/pancuronium caused undesirable rises in heart rate and blood pressure.