Anesthesia and analgesia
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Anesthesia and analgesia · Feb 1984
Fentanyl- and sufentanil-oxygen-pancuronium anesthesia for cardiac surgery in infants.
The safety and efficacy of fentanyl-oxygen (50 and 75 micrograms/kg) and sufentanil-oxygen (5 and 10 micrograms/kg) were studied in 40 infants undergoing repair of complex heart defects. When fentanyl or sufentanil was given simultaneously with pancuronium, induction of anesthesia was rapid and smooth with only mild and clinically insignificant hemodynamic changes. Hemodynamic responses to tracheal intubation were completely blocked, whereas hemodynamic responses to surgical incision and sternotomy were partially and variably blocked. ⋯ Transcutaneous oxygen tensions increased with induction, intubation, and surgical stimulation with both fentanyl and sufentanil, even in cyanotic patients with right to left shunts. Fentanyl- and sufentanil-oxygen-pancuronium anesthesia were both safe and effective for cardiac surgery in infants. This study raises the question of possible beneficial effects of high dose fentanyl and sufentanil in blunting stress responses in the pulmonary circulation, a critical aspect of anesthesia and intensive care in the infant and neonate.