Journal of cardiothoracic anesthesia
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J Cardiothorac Anesth · Feb 1988
Oxygenation and hemodynamic changes during one-lung ventilation: effects of CPAP10, PEEP10, and CPAP10/PEEP10.
The effects of 10 cm H2O positive end-expiratory pressure (PEEP10), 10 cm H2O continuous positive airway pressure (CPAP10), and their combination (CPAP10/PEEP10) on oxygenation and hemodynamics were studied in 20 patients undergoing one-lung ventilation (OLV) with 50% nitrous oxide, isoflurane, and oxygen. Compared to OLV alone, CPAP10 and CPAP10/PEEP10 significantly increased PaO2 (from 80 +/- 6 to 125 +/- 11 and 137 +/- 17 mmHg, respectively); increased SaO2 (from 93.9 +/- 0.8 to 97.1 +/- 0.5 and 97.0 +/- 0.6%, respectively); and decreased Qs/Qt% (from 36.4 +/- 1.6 to 26.2 +/- 2.0 and 23.2 +/- 2.0%, respectively). ⋯ Application of CPAP10, PEEP10 or their combination had no significant effect on heart rate, arterial, pulmonary arterial, mean pulmonary capillary wedge or central venous pressures, systemic or pulmonary vascular resistances, or mixed venous oxygen saturation. Overall, CPAP10 had the most beneficial effect on oxygenation and hemodynamics during OLV with 50% N2O, isoflurane and oxygen.
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J Cardiothorac Anesth · Feb 1988
Randomized Controlled Trial Clinical TrialCatecholamine responses to anesthetic induction with fentanyl and sufentanil.
In a randomized study, the authors examined the changes in plasma epinephrine and norepinephrine concentrations associated with induction of anesthesia and surgery in 33 patients with good ventricular function undergoing elective coronary artery surgery. After premedication with morphine and scopolamine, patients received either fentanyl, 100 micrograms/kg (n = 16), or sufentanil, 15 micrograms/kg, (n = 17), intravenously (IV), over 10 minutes to induce anesthesia. Metocurine, 0.42 mg/kg, IV, produced muscle relaxation. ⋯ Induction-related changes in arterial pressure and pulmonary capillary wedge pressure were significantly correlated with changes in the logarithm of plasma norepinephrine concentration. Similar degrees of endogenous norepinephrine release appear to accompany induction with equipotent doses of fentanyl and sufentanil in patients premedicated with morphine and scopolamine. Norepinephrine release may influence the hemodynamic response to induction with narcotics.