HEMODYNAMIC-EFFECTS OF ANESTHETIC INDUCTION WITH ELTANOLONE-FENTANYL VERSUS THIOPENTAL-FENTANYL IN CORONARY-ARTERY BYPASS PATIENTS

We evaluated the hemodynamic profile of eltanolone and fentanyl versus thiopental and fentanyl anesthetic induction in patients with documen ted coronary artery disease. Fifty patients scheduled for coronary art ery bypass grafting were randomly assigned to two treatment groups (25 patients each). Anesthesia was induced by eltanolone (0.5 mg/kg) or b y thiopental (3 mg/kg). Each patient also received 3 mu g/kg fentanyl and 0.1 mg/kg vecuronium. Heart rate, arterial, pulmonary arterial, ce ntral venous, and pulmonary capillary wedge pressures, and cardiac out put were determined in the awake state, 2 min after induction of anest hesia, and at 1 and 5 min after intubation, which was performed 3 min after induction. Between-group statistics showed significantly (P < 0. 05) lower mean arterial pressure and systemic vascular resistance for eltanolone-treated patients at all measuring points. Pulmonary capilla ry wedge pressure was lower at 1 min after intubation; left ventricula r stroke work index was lower at 1 and 5 min after intubation in the e ltanolone group. We conclude that the lower mean arterial pressure wit h eltanolone as compared to thiopental is a result of greater peripher al vasodilation.