Fast-Track Anaesthesia in Off-Pump Coronary Surgery: A Comparison of Normotensive and Hypertensive Patients

Turk J Anaesthesiol Reanim. 2018 Aug;46(4):276-282. doi: 10.5152/TJAR.2018.70493. Epub 2018 Mar 1.

Abstract

Objective: In this study, our aim was to investigate the efficacy and sufficiency of bispectral indeks (BIS) guided remifentanil-desflurane anaesthesia on intraoperative haemodynamic stability in both normotensive and hypertensive patients undergoing off-pump coronary artery bypass surgery.

Methods: Thirty adult, ASA I-III patients undergoing elective off-pump coronary surgery were included in the study. According to the presence of essential hypertension preoperatively, patients were divided into two groups. Haemodynamic parameters were recorded at 11 time points during the operation.

Results: There were no differences in the demographic data, heart rate and intraoperative and postoperative parameters between the groups. Arterial blood pressure and additional requirement of remifentanil were found to be significantly higher in the hypertensive group intraoperatively.

Conclusion: In patients undergoing off-pump coronary revascularisation surgery, intraoperative haemodynamic stabilisation with remifentanil-desflurane anaesthesia under BIS guidance was safely provided, but higher remifentanil doses were required in hypertensive patients.

Keywords: Desflurane; anaesthesia; fast-track anaesthesia; haemodynamic stabilisation; hypertension; off-pump coronary revascularisation; off-pumpcardiac surgery; remifentanil.