Abstract
Transthoracic two-dimensional echocardiography was used to measure left ventricular diameter in end-systole and end-diastole during anesthetic induction in 11 patients before coronary artery bypass grafting. Midazolam, 0.1 mg/kg, and fentanyl, 6 to 10 μg / kg, were used followed by pancuronium, 0.1 mg/kg. Lidocaine, 1.5 mg/kg, was given topically in the airways before intubation. During induction of anesthesia there was a gradual decrease in diastolic diameter (preload) and in systolic diameter and pressure (afterload). The decrease in end-diastolic diameter from 4.6 cm to 3.9 cm indicated a decrease in preload, defined as end-diastolic volume, by approximately 34%. These results are in agreement with earlier findings using calculated ventricular volumes, based on the determination of either ejection fraction with radionuclide cardiography or stroke volume with thermodilution, during induction of anesthesia with thiopental, diazepam, fentanyl, and pancuronium.
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