Propofol-alfentanil versus fentanyl-midazolam in coronary artery surgery

Comparison of Hemodynamic Changes During Induction With Modified Propofol Protocol in Normal and Low Lv Function Patients Undergoing Cabg Surgery

“…There is sufficient data in literature which suggest propofol-fentanyl anesthesia is an acceptable technique for CABG surgery. 6,7 A randomized trial of anesthetic induction agents in patients with coronary artery disease and left ventricular dysfunction was done by Singh R 8 comparing the four anesthetic agents Etomidate, Midazolam, Thiopentone and propofol concluded that all four drugs were acceptable for induction in patients with coronary artery disease and left ventricular dysfunction despite a 30 -40% decrease in the cardiac index. They found significant decrease in the heart rate in comparison to the baseline (-7 to -15%), mean arterial pressure (-27 to -32%) and cardiac index (-36 to -38%) after induction in all four groups with their technique of induction 8 depend to a great extent, on the technique, skill, and experience of drug administration by the clinician (e.g., slow infusion vs. rapid bolus).…”

Comparison of preincisional and postincisional parasternal intercostal block on postoperative pain in cardiac surgery

“…7,8 Hemodynamic fluctuations are relatively common during cardiac surgery and can pose serious challenges during skin incision (SI), sternotomy (ST), and sternal retractor placement (SR) in patients undergoing cardiac surgery. 9,10 Preemptive analgesia has been reported to prevent the establishment of central sensitization caused by incisional and inflammatory injuries. 11,12 Therefore, the purpose of this study was to evaluate the effectiveness of preoperative ultrasound guided intercostal block compared to conventionally practiced postoperative intercostal block in reducing the postoperative pain after cardiac surgery.…”

“…Preincisional (preoperative) infiltration/nerve block with local anesthetic agents has been used in several surgical settings with variable success in achieving intraoperative hemodynamic stability, opioid consumption, and postoperative analgesia 7,8 . Hemodynamic fluctuations are relatively common during cardiac surgery and can pose serious challenges during skin incision (SI), sternotomy (ST), and sternal retractor placement (SR) in patients undergoing cardiac surgery 9,10 . Preemptive analgesia has been reported to prevent the establishment of central sensitization caused by incisional and inflammatory injuries 11,12 .…”