Hemodynamic changes during total intravenous propofol anesthesia in ischemic cardiac patients · undergoing noncardiac surgery

Abstract

total of 90 patients (31 males, 59 females) with electrocardiographic changes indicative of cardiac ischemia were included in this study. The aim of this study was to evalute the anesthetic effects of

propofol induction and maintenance in these ischemic patients undergoing elective major abdorninal surgery. Two closes of propofol continuous infusion (200 tg/kg/ min, and 100 ug!kg/min) used for maintenance of anesthesia were evaluated. Anesthesia was induced intravenously with propofol (1.5 mg!kg) in addition to a low dose of fentanyl (3 tg/kg). Subsequently, anesthesia was maintained by a continuous propofol infirsion.The patients were classified into two equal groups (fourty five patients each) according to the continuously inf11Sed dose of propofol used for maintenance of anesthesia. The first group, received continuous propofol infusion in a rate of200 tg/kg/min (group I), and the second group received continuous propofol infusion in a dose of 100 tg/kg/min (groupii). Vecuronium was the muscle relaxant used for endotracheal intubation and maintenance of relaxation during surgery. Ventilation was controlled mechanically using 100'% oxygen. Incremental do:.. of fentanyl (50 J.!g) were given during anesthesia to maintain systolic blood pressure or heart rate of approximately not more than 20% above baseline value. Discontinuation of propof\)1 infusion was clone after the en4 of surgery. Extubation was clone after reversal of neuromuscular blockade with n ostigmine and atropine.

' The following were evaluated during anesthesia and smgery in both groups

of patients: I

1) Th6 SAP, DAP, MAP, HR, RPP, SVR, CI, SVJ, LVSWI. and PCWP were the cardio ascular effects investigated. They were measured when the patients were