Surgical Stimulation during High-Dose Fentanyl Anaesthesia: Effects of Dehydrobenzperidol on the Haemodynamics and Myocardial Oxygenation

Publisher Website
Google Scholar
Abstract
Twenty-four patients undergoing a coronary artery bypass grafting operation with high-dose fentanyl (100 .mu.g/kg -lorazepam-oxygen anesthesia) were divided into a control group and a group receiving in addition 0.25 mg kg dehydrobenzperidol (DHBP) before the skin incision (DHBP-group). The changes in the central and coronary hemodynamics and the myocardial oxygenation were studied and compared between the 2 groups during the skin incision and sternotomy to evaluate the possible effects of the DHBP in preventing the harmful haemodynamic effects of surgical stimulation during high-dose fentanyl anesthesia. In the control group a marked increase in the systemic vascular resistance and mean arterial pressure was seen during surgery. This hemodynamic stimulation was prevented by DHBP during the skin incision and markedly reduced during the sternotomy. Regarless of whether or not DHBP was given, a significant increase in the myocardial O2 consumption was observed during the sternotomy; in the control group, the increase was slightly higher and was compensated by a greater increase in the myocardial O2 extraction. No significant changes were seen in the coronary sinus blood flow or coronary vascular resistance in either group. The surgery caused no change in the myocardial lactate extraction in either group, although myocardial lactate production was observed in 1 control patient and the myocardial lactate extraction was markedly reduced in 2 other control patients and 1 DHBP patient.