Effects Of Different Dose Fentanyl On Stress Responses To Beating Heart Surgery With Cardiopulmonary Bypass

Objective: To study the effects of different dose fentanyl on stress responses to beating heart surgery with CPB and investigate the best dose of fentanyl using in beating heart surgery.Methods: Twenty-seven patient of ASD,VSD,MIMS under fentanyl-propofol-isoflurane-oxygen anesthesia were selected. They were divided into three groups randomly. Each group was nine cases. The main narcotic analgesic was fentanyl. The dose of fentanyl in group one (G1) was 10μg/kg; Group two (G2) was 30μg/kg; Group three (G3) was 50μg/kg. HR,MAP,BS,ACTH,AⅡ,F of all patients were observed and detected during operation. Awareness time and extubation time of patients were recorded after operation.Results: HR remained stable in three groups patients during operation. MAP decreased significantly (P<0.05 ) during perfusion comparing with preanesthesia. BS,ACTH,AⅡ, F were increased significantly (P<0.05 ) during and after perfusion comparing with before perfusion. The values of G1 was maximum in the same time after anesthesia, G3 was minimum. The values of ACTH,AⅡ,F in G1 were increased significantly (P<0.01) comparing with G2 and G3. G2 was not significantly (P>0.05) comparing to G3. The time of awareness and extubation in G1 was minimum, in G3 was maximum. The values of G3 were increased significantly (P<0.05 ) comparing with G1 and G2. G3 was not significantly (P>0.05) comparing to G2.Conclusions: Stress responses to beating heart surgery with CPB were inhibited by fentanyl. The best dose of fentanyl was 30～50μg/kg in this operation.