Myocardial metabolism during anaesthesia with propofol--low dose fentanyl for coronary artery bypass surgery.

We have studied the haemodynamic and myocardial effects of propofol-fentanyl anaesthesia in 12 patients undergoing coronary artery bypass surgery during the pre-bypass period. The induction dose of propofol was 1.5 mg kg-1 and mean infusion rate during maintenance was 4.48 mg kg-1 h-1 (range 1.87-7.24 mg kg-1 h-1). The total dose of fentanyl was 30 micrograms kg-1. The haemodynamic changes indicated myocardial depression and peripheral vasodilatation. Coronary sinus flow and indicators of global myocardial perfusion (myocardial oxygen consumption, myocardial lactate extraction) did not change. Although not excluding regional myocardial ischaemia, these results show that propofol-fentanyl anaesthesia has no major adverse effects on cardiac function.