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May 1, 1989Anesthesia & Analgesia

Sufentanil Does Not Block Sympathetic Responses to Surgical Stimuli in Patients Having Coronary Artery Revascularization Surgery

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Key result

During sternotomy, 56% of patients receiving sufentanil anesthesia developed hypertension and 56% showed signs of myocardial ischemia, demonstrating incomplete protection from sympathetic responses.

Why the study?

Does sufentanil anesthesia block sympathetic responses and prevent myocardial ischemia during surgical stimuli in patients undergoing coronary artery bypass surgery?

Population

16 male patients scheduled for elective coronary artery bypass surgery, on maintenance doses of calcium…

Comparison

Moderate dose sufentanil plus nitrous oxide… vs The two sufentanil dosing regimens were compared…

Design

Cohort

Follow-up

Intraoperative (up to sternotomy)

Authors

HSH. SonntagUniversity of GöttingenHSHeidrun StephanUniversitätsmedizin GöttingenHLHarald LangePhilipps University of Marburg

Discussion

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Implication

Sufentanil may not fully protect against sympathetic responses and ischemia during sternotomy; hypothesis-generating for alternative regimens in CABG.

Structured PICO

Does sufentanil anesthesia block sympathetic responses and prevent myocardial ischemia during surgical stimuli in patients undergoing coronary artery bypass surgery?

P
Population
16 male patients with coronary heart disease scheduled for elective coronary artery bypass surgery.
I
Intervention
Moderate dose sufentanil (1 μg·kg−1 + 0.015 μg·kg−1 ·min−1) plus nitrous oxide (30% O2/70% N2O) anesthesia (n=8) or high-dose sufentanil/O2 anesthesia (10 μg·kg−1 + 0.15 μg·kg−1·min−1) without N2O (n=8).
C
Comparator
The two sufentanil dosing regimens were compared to each other.
O
Outcome
Cardiovascular dynamics, myocardial blood flow, myocardial oxygen consumption, myocardial lactate balance, and hypo-xanthine release measured before induction, 20 min after induction, and during sternotomy.surrogate

Sufentanil anesthesia, whether at moderate doses with nitrous oxide or high doses without, does not adequately protect the myocardium from autonomic sympathetic responses and ischemia during sternotomy in CABG patients.

Cite This Study

Sonntag et al. (1989) studied Coronary heart disease (n=16). Sufentanil vs. High-dose sufentanil without N2O was evaluated on Myocardial ischemia during sternotomy. During sternotomy, 56% of patients receiving sufentanil anesthesia developed hypertension and 56% showed signs of myocardial ischemia, demonstrating incomplete protection from sympathetic responses.

synapsesocial.com/papers/6a92dd41b1fb2e37bf1f6df5https://doi.org/10.1213/00000539-198905000-00007
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Sufentanil Does Not Block Sympathetic Responses to Surgical Stimuli in Patients Having Coronary Artery Revascularization Surgery1990 · 22 citations
  2. 2Cardiovascular Effects of Sufentanil Anesthesia1982 · 87 citations
  3. 3A Comparison of Fentanyl-O2 and Sufentanil-O2 for Cardiac Anesthesia1986 · 40 citations
  4. 4A Comparison of Fentanyl???O2 and Sufentanil???O2 for Cardiac Anesthesia1985 · 43 citations
  5. 5Comparison of Sufentanil and Enflurane-Nitrous Oxide Anesthesia for Myocardial Revascularization1986 · 35 citations