Propofol and Fentanyl Take Longer for Induction of Anesthesia in Aortic Regurgitation: A Case-Controlled Prospective Study

Abstract

This study was conducted to determine if induction time of anesthesia in patients with aortic regurgitation (AR) is different from patients with a normal aortic valve (AV). A prospective, case-control study. A single institutional study conducted in a tertiary care teaching hospital. Twenty-four male patients scheduled for cardiac surgery, group I (n = 12) patients with competent AV and group 2 (n = 12) with severe AR. General anesthesia was induced by intravenous infusion of propofol and fentanyl. Continuous measurements of heart rate, intra-arterial blood pressure, and bispectral index were recorded. Induction doses of propofol and fentanyl were analyzed and compared. There was significant difference between the 2 groups in terms of induction time of anesthesia (mean ± SD 308 ± 68.2 seconds in group 1 v 445 ± 97.9 seconds in group 2). The patients in group 2 (AR) required significantly larger doses of propofol (0.91 ± 0.40 mg/kg) than the patients in group 1 (0.49 ± 0.17 mg/kg). Similarly, fentanyl dose was increased in the group 2 patients (20.8 ± 15.9 µg/kg) compared with the group 1 patients (9.2 ± 2.9 µg/kg). The authors concluded that there was a significant prolongation of the induction time of anesthesia and the need of larger doses of propofol and fentanyl by slow intravenous infusion regimen in patients with AR compared with patients with a competent aortic valve.