4857
document
Comparison of alfentanil , fentanyl and sufentanil for total intravenous anaesthesia with propofol in patients undergoing coronary artery bypass surgery . We have studied the pharmacokinetics and pharmacodynamics of alfentanil , fentanyl and sufentanil together with propofol in patients undergoing coronary artery bypass graft surgery ( CABG ) . Sixty patients ( age 40-73 yr , 56 male ) were assigned randomly to receive alfentanil , fentanyl or sufentanil and propofol . Plasma concentrations of these drugs and times for the plasma concentration to decrease by 50 % ( t50 ) and 80 % ( t80 ) after cessation of the infusion were determined . Times were recorded to awakening and tracheal extubation . Total dose and plasma concentrations of propofol were similar in all groups . Mean total doses of alfentanil , fentanyl and sufentanil were 443 , 45 and 4.4 micrograms kg-1 , respectively . Time to awakening did not differ significantly . In patients receiving fentanyl , the trachea was extubated on average 2 h later than in those receiving sufentanil and 3 h later than in those receiving alfentanil ( P < 0.05 ) . The t80 of fentanyl was longer ( P < 0.05 ) than that of alfentanil or sufentanil , and there was a linear correlation between the t80 of the opioid and the time to tracheal extubation ( r = 0.51 ; P < 0.01 ) . However , the t50 values for these opioids were similar and did not correlate with recovery time . In conclusion , patients undergoing CABG and who were anaesthetized with fentanyl and propofol needed mechanical ventilatory support for a significantly longer time than those receiving alfentanil or sufentanil and propofol . On the basis of the interindividual variation observed , the time to tracheal extubation was most predictable in patients receiving alfentanil and most variable in patients receiving fentanyl , a finding which may be important if the patients are transferred to a step-down unit on the evening of the operation .
4858
Intervention_Pharmacological
alfentanil
4859
Intervention_Pharmacological
fentanyl
4860
Intervention_Pharmacological
sufentanil
4861
Intervention_Pharmacological
propofol
4862
Intervention_Pharmacological
alfentanil
4863
Intervention_Pharmacological
fentanyl
4864
Intervention_Pharmacological
sufentanil
4865
Intervention_Pharmacological
propofol
4866
Intervention_Pharmacological
alfentanil
4867
Intervention_Pharmacological
fentanyl
4868
Intervention_Pharmacological
sufentanil
4869
Intervention_Pharmacological
propofol
4870
Intervention_Pharmacological
alfentanil
4871
Intervention_Pharmacological
fentanyl
4872
Intervention_Pharmacological
sufentanil
4873
Intervention_Pharmacological
fentanyl
4874
Intervention_Pharmacological
sufentanil
4875
Intervention_Pharmacological
alfentanil
4876
Intervention_Pharmacological
fentanyl
4877
Intervention_Pharmacological
alfentanil
4878
Intervention_Pharmacological
sufentanil
4879
Intervention_Pharmacological
fentanyl
4880
Intervention_Pharmacological
propofol
4881
Intervention_Pharmacological
alfentanil
4882
Intervention_Pharmacological
sufentanil
4883
Intervention_Pharmacological
propofol
4884
Intervention_Pharmacological
alfentanil
4885
Intervention_Pharmacological
fentanyl
4886
Outcome_Physical
pharmacokinetics and pharmacodynamics
4887
Outcome_Physical
Plasma concentrations
4888
Outcome_Other
times for the plasma concentration to decrease by 50 %
4889
Outcome_Physical
Total dose and plasma concentrations
4890
Outcome_Other
Mean total doses
4891
Outcome_Physical
Time to awakening
4892
Outcome_Physical
trachea
4893
Outcome_Physical
t80
4894
Outcome_Physical
t80
4895
Outcome_Other
time to tracheal extubation
4896
Outcome_Physical
t50 values
4897
Outcome_Other
recovery time
4898
Outcome_Other
mechanical ventilatory support
4899
Outcome_Other
time to tracheal extubation
4900
Participant_Condition
patients undergoing coronary artery bypass surgery .
4901
Participant_Condition
patients undergoing coronary artery bypass graft surgery ( CABG ) .