BACKGROUND: Cardiovascular drugs are frequently used to assist myocardial function after discontinuation of cardiopulmonary bypass (CPB) in the open heart surgery (OHS) because of unstable hemodynamics. At this time we should always consider that the radial arterial pressure (RAP) may be lower than the aortic pressure (AP). In this study we evaluated the difference between AP and RAP in propofol-alfentanil anesthesia.

METHODS: 28 patients undergoing elective OHS were randomly allocated into a midazolam-fentanyl (MA) group (n = 14) or a propofol-alfentanil (PA) group (n = 14). Anesthesia in the MF group consisted of midazolam and fentanyl with intermittent bolus injection, and anesthesia in the PA group consisted of propofol and alfentanil with continuous in fusion. RAP and AP in the two groups were recorded for 5 minutes after CPB discontinuation.

RESULTS: No significant difference was founded between the two groups in age, weight, height, CPB time, aortic cross clamping (ACC) time, or temperature. There was a relatively high correlation between the difference of systolic AP-RAP and CPB time (r = 0.01), and ACC time (0.001). The systolic and mean blood pressure difference between the aorta and the radial artery in the MF group was significantly greater than in the PA group.

CONCLUSIONS: This findings suggest that propofol-alfentanil anesthesia in OHS may be more helpful for hemodynamic management after CPB discontinuation than midazolam-fentanyl anesthesia.