Abstract
The effect of fentanyl-enflurane/nitrous oxide anesthesia on hemodynamic state was investigated in twelve patients with old myocardial infarctions undergoing noncardiac surgery. The anesthetic method cosisted of heavy premedication, induction with fentanyl and pancuronium, and enflurane andnitrous oxide in oxygen.
Heart rate decreased after administration of premedication without any changes in blood pressure. Induction with low-dose f entanyl (10μg•kg-1) avoided unfavorable circuratory responses to tracheal intubation and maintenance with enflurane (0.3∼1.0%) decreased systemic arterial pressure with little depression of myocardial function. The only problem was an increase in heart rate after endotracheal extubation which could have produced an increase in myocardial oxygen demand. An injection of either lidocaine or β-adrenergic blocking agent prior to extubation might be considered to settle the problem.
Although the condition after extubation was not ideal enough for the patients with old myocardial infarction, this anesthetic method could be one of the safe and beneficial procedures for these cases.
