Author/Editor		Mekiš, Dušan
Title		Primerjava učinkov remifentanila in fentanila na obtočila med uvodom v anestezijo za premostitev venčnih arterij
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2002
Volume		str. 46
Language		slo
Abstract		During induction of anesthesia the anesthesiologist has to insert the orotracheal tube by means of direct laryngoscopy. This is a painful procedure during which stress hormones can be released, which cause an increased blood pressure and heart rate. The response of the circulatory system to direct laryngoscopy and orotracheal intubation can cause myocardial ischemia and myocardial infarction. The classical anesthesiologic technique is general anesthesia with a large dose of fentanyl which successfully blocks the stress response of the organism, but on the other hand causes a prolonged postoperative respiratory depression. Respiratory depression averts the use the technique of fast track heart surgery, so smaller doses of fentanyl are recommended in modern anesthesia for heart surgery. Because of the fast elimination of remifentanyl in the plasma we can alter the concentration of remifentanyl in plasma by altering the speed of infusion. This enables us to adjust the depth of analgesia to the phase of the operation and succesfully block the stress response of the organism followed by a quick awakening of the patient with a quick transition to spontaneous breathing, which enables us to practice fast track heart surgery. In our study we compared the effects of fentanyl / remifentanyl on the circulatory system during induction of anesthesia in patients with ischemic heart disease, which undergoing elective aortocoronary bypass surgery. Our hypothesis started that, compared to fentanyl, we can reach a greater stability of the circulatory system and reduce the need for fenylefrin or nitroglycerin for regulation if the blood pressure during the induction of anesthesia for heart susrgery by altering the constant dose of remifentanyl. We studied 54 patients undergoing elective aortocoronary bypass surgery. (Abstract truncated at 2000 characters).
Descriptors		CORONARY DISEASE ANESTHESIA, GENERAL PREANESTHETIC MEDICATION FENTANYL PROPOFOL INTUBATION, INTRATRACHEAL LARYNGOSCOPY CORONARY ARTERY BYPASS PANCURONIUM CARDIAC OUTPUT BLOOD PRESSURE RESPIRATION, ARTIFICIAL HEART RATE CENTRAL VENOUS PRESSURE