Haemodynamic Effects of Fentanyl or Alfentanil as Adjuvants to Etomidate for Induction of Anaesthesia in Cardiac Patients

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Abstract
The comparative hemodynamic effects of alfentanil 5 mg vs. fentanyl 0.5 mg when administered in combination with etomidate for induction of anesthesia was studied in patients undergoing cardiac surgery. Both groups manifested significant decreases in heart rate (17-22%), cardiac index (12-25%) and mean pulmonary artery pressure (4-17%). The mean arterial pressure was decreased in both groups; however, the decrease was significantly greater in the alfentanil group. In contrast to the fentanyl group, the systemic vascular resistance was transiently decreased in the alfentanil group. Apparently, alfentanil is associated with a greater degree of cardiovascular depression than fentanyl when used in combination with etomidate as part of an induction sequence in cardiac surgery patients.