An efficacy comparison of fentanyl and remifentanil during off-pump coronary artery bypass graft surgery

Background: This study aims to compare the effects of fentanyl and remifentanil on hemodynamic stability, release of troponin-I and early extubation during off-pump coronary artery bypass graft (CABG) surgery. Methods: Forty patients who were scheduled for elective offpump CABG surgery were randomly assigned to two groups. The remifentanil group received 1 μg/kg-1 remifentanil over one minute for induction, followed by 0.1-1 μg/kg-1 min-1 continuous infusion plus midazolam 0.1-0.15 mg/kg-1 for maintenance dose. The fentanyl group received 10-15 μg/kg-1 fentanyl over one minute for induction and 0.1-1 μg/kg-1 min-1 continuous infusion plus midazolam 0.1-0.15 mg/kg-1 for maintenance dose. Rocuronium bromide at 0.6-0.8 mg/kg-1 was administered to facilitate tracheal intubation. Midazolam infusion at 0.4-1 μg/kg-1 min-1 was initiated for maintenance therapy. Results: The depth of anesthesia was adjusted to maintain a BIS value between 40-60. Following skin incision and sternotomy, systolic arterial pressure was lower in the remifentanil group compared to the fentanyl group (115±14 mmHg vs. 130±22 mmHg p