Journal of cardiothoracic anesthesia
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J Cardiothorac Anesth · Dec 1987
The incidence of awareness, and amnesia for perioperative events, after cardiac surgery with lorazepam and fentanyl anesthesia.
One hundred patients (mean age 59 +/- 10 years) were premedicated with morphine, 0.15 mg/kg, and scopolamine, 0.008 mg/kg. Anesthesia was induced with lorazepam, 50 microg/kg, followed by fentanyl, 50 microg/kg, oxygen and pancuronium, 0.15 mg/kg. Isoflurane was given for short periods before and after cardiopulmonary bypass to 57 patients when hypertension was uncontrolled by addition of fentanyl and/or nitroglycerin. ⋯ In the two postoperative periods (morning of the day after surgery and intensive care stay), 9% and 15% of patients had complete, and 35% and 47% of patients exhibited partial amnesia. Amnesia was statistically significantly greater in patients over 60 years of age in the preinduction period. Duration of cardiopulmonary bypass did not affect the incidence of amnesia.
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J Cardiothorac Anesth · Dec 1987
Randomized Controlled TrialThe role of intrathecal morphine in the anesthetic management of patients undergoing coronary artery bypass surgery.
The study was undertaken to assess the effects of intrathecal morphine (ITM) on perioperative hemodynamics, and anesthetic and postoperative analgesic requirements in patients anesthetized with fentanyl/enflurane undergoing coronary artery bypass surgery. Forty patients were randomized in a double-blind fashion to receive either intrathecal morphine or saline. Nineteen patients received ITM, 0.02 mg/ kg, and 21 intrathecal saline (ITS) after induction of anesthesia. ⋯ No significant difference was found between ITM and ITS groups for postoperative requirements of morphine (3.5 +/- 0.5 v 4.5 +/- 0.6 mg), diazepam (5.6 +/-1.25 v 3.9 +/- 1.26 mg), and vasodilators (6 v 13 patients), respectively. Comparable and significant reductions of peak expiratory flow rates (PEFR), forced vital capacity (FVC), and forced expiratory volume (FEV1) occurred in both groups postextubation when compared with preoperative values. Intrathecal morphine at the dose of 0.02 mg/kg does not offer any clear benefit to patients anesthetized with fentanyl, 40 microg/kg, for coronary artery bypass surgery.