Sufentanil with and without diazepam for coronary artery bypass graft surgery

Abstract

We studied the sufentanil-sparing effect of diazepam for anesthesia induction and compared stress responses (hemodynamics, plasma catecholamine levels) and sufentanil and diazepam plasma levels during sufentanil anesthesia with or without diazepam. Sixteen aortocoronary bypass surgery patients were randomly assigned to receive diazepam (D) 100 micrograms/kg (Group DS) or not (Group S), then sufentanil (Sf) infused at 150 micrograms/min until unconsciousness (U). After tracheal intubation, the Sf dose for U (Sfu) was repeated, preceded in Group DS by D 150 micrograms/kg. Group DS patients require lower Sfu doses (2.01 +/- 0.23 micrograms/kg vs 4.87 +/- 0.63 micrograms/kg (P < 0.05) and plasma Sf levels (236 +/- 47 ng/100 ml vs 593 +/- 118 ng/100 ml (P < 0.01) and had similar or lower heart rate, systolic and diastolic blood pressure, rate-pressure product, and plasma norepinephrine levels than S patients. Linear regression of mean plasma norepinephrine and sufentanil levels gave correlation coefficients of -0.205 in S and -0.90 in DS (p < 0.05).