• K M Sherry, J Sartain, J H Bell, and G A Wilkinson.
• Department of Anesthesia, Northern General Hospital, Sheffield, England.
• J. Cardiothorac. Vasc. Anesth. 1995 Aug 1;9(4):368-72.

ObjectivesThis study compared the hemodynamic effects of a propofol infusion with fentanyl analgesia in patients undergoing cardiac surgery with normal and low cardiac output states. Low cardiac output was defined as a cardiac index less than 2.5 L/min/m2 with a minimum pulmonary capillary wedge pressure of 7 mmHg.DesignA prospective and open study.SettingA single center cardiothoracic unit within a teaching hospital.ParticipantsPatients were assigned to group P, poor cardiac output or group N, normal cardiac output, after thermodilution pulmonary artery catheter assessments.InterventionsBoth groups received a propofol infusion, 8 mg/kg/hr, until induction of anesthesia, followed by 4 mg/kg/hr until the intensive care unit. Fentanyl, 15 micrograms/kg, and pancuronium, 0.15 mg/kg, were administered after induction. The lungs were ventilated with oxygen.Measurements And Main ResultsHemodynamic assessments were repeated at intervals until cardiopulmonary bypass. Changes within and between groups were compared using t tests on percentage change from baseline. Group N had significantly greater decreases in cardiac index, stroke volume, and left ventricular stroke work index than group P. There were comparable decreases in mean arterial pressure on induction of anesthesia, 14% and 8% in group N and group P, respectively. In both groups, right ventricular ejection fraction was unchanged.ConclusionsThe use of a propofol infusion for induction and maintenance of anesthesia in patients with low cardiac output states undergoing cardiac surgery is not contraindicated.

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