Efficacy and safety of total intravenous anesthesia by targeting effect-site compartment TCI of propofol and sufentanil in off-pump coronary artery bypass graft surgery

Abstract

Objective To approach the method of propofol and sufentanil effect-site compartment TCI (target controlled infusion) in off-pump coronary artery bypass graft (CABG) surgery.Methods Thirty-six patients undergoing CABG surgery, ASAⅠ~Ⅲ,EF≥40%, were randomly assigned to either of the group L or group H equally. The procedure had 4 periods: the anesthesia induction period, the pre-grafting period, the grafting period and the post-grafting period. In group L the predetermined sufentanil effect-site concentrations (Ce) for each period were: 0.4 μg/L, 0.8 μg/L, 0.5 μg/L and 0.5 μg/L ; while in group H were: 0.6 μg/L, 1.2 μg/L, 0.7 μg/L, 0.7 μg/L. Results In group L there were 4 patients' tracheal intubation could not be fulfilled under the predetermined Ce, and 3 patients received isoflurane anesthesia as supplementary in the pre-grafting period. The average total dose of propofol of group L was (19.6±3.30, n=14) mg/kg, and that of group H (17.4±3.21, n=16) mg/kg. Conclusion Propofol and sufentanil TCI can be of good choice in off-pump CABG surgery. The recommended Ce are: Induction period, sufentanil 0.6 μg/L combined with propofol 1.5 mg/L ~2.0 mg/L; Pre-grafting period, sufentanil 1.2 μg/L, propofol 2.5 mg/L ~3.5 mg/L; Grafting and post-grafting period, sufentanil 0.5 μg/L ~0.7 μg/L, propofol 1.5 mg/L ~2.5 mg/L.