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Korean Journal of Anesthesiology 2004;47(5):671-675.
DOI: https://doi.org/10.4097/kjae.2004.47.5.671   
Aortic/Radial Arterial Pressure Difference during Weaning from Cardiopulmonary Bypass in Open Heart Surgery Patients Anesthetized with Propofol-Alfentanil.
Yong Bo Jeong, Ja Young Ju, Seong Deok Kim, In Cheol Choi
1Department of Anesthesiology and Pain Medicine, College of Medicine, University of Ulsan, Seoul, Korea. ybjeong@amc.seoul.kr
2Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
Abstract
BACKGROUND
Cardiovascular drugs are frequently used to assist myocardial function after discontinuation of cardiopulmonary bypass (CPB) in the open heart surgery (OHS) because of unstable hemodynamics. At this time we should always consider that the radial arterial pressure (RAP) may be lower than the aortic pressure (AP). In this study we evaluated the difference between AP and RAP in propofol-alfentanil anesthesia.
METHODS
28 patients undergoing elective OHS were randomly allocated into a midazolam-fentanyl (MA) group (n = 14) or a propofol-alfentanil (PA) group (n = 14). Anesthesia in the MF group consisted of midazolam and fentanyl with intermittent bolus injection, and anesthesia in the PA group consisted of propofol and alfentanil with continuous in fusion. RAP and AP in the two groups were recorded for 5 minutes after CPB discontinuation.
RESULTS
No significant difference was founded between the two groups in age, weight, height, CPB time, aortic cross clamping (ACC) time, or temperature. There was a relatively high correlation between the difference of systolic AP-RAP and CPB time (r = 0.01), and ACC time (0.001). The systolic and mean blood pressure difference between the aorta and the radial artery in the MF group was significantly greater than in the PA group.
CONCLUSIONS
This findings suggest that propofol-alfentanil anesthesia in OHS may be more helpful for hemodynamic management after CPB discontinuation than midazolam-fentanyl anesthesia.
Key Words: pressure; aorta; radial artery; propofol; cardiac anesthesia


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