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Clinical Observation on Etimidate-Fentanyl for Induction of Anesthesia in Patients undergoing Cardiac Valve Replacement

Objective:To observe the clinical effects of etomidate-fentanyl on induction of anesthesia in patients undergoing cardiac valve replacement. Methods: Endotracheal intubation were performed on 40 patients with cardiac function Ⅱ～Ⅲ subjected to cardiac valve replacement under anesthesia induced by fentanyl 5 μg/kg, pancuronium 0.08 mg/kg and etomidate 0.3 mg/kg. Among the patients, 13 with cardiac function Ⅲ～Ⅳhad history of repeated attacks of cardiac failure, 22 patients underwent mitral valve replacement, 11 underwent aortic valve replacement and 7 had replacement of both valves. Results: Adverse reactions such as pain at the injection site, amyostasia and involuntary muscular movement were not observed and nor were there any special changes in HR and ECG during induction. The SBP, MAP decreased from 16.7±2.3(kPa), 12.5±3.1(kPa) to 12.8±3.9( P 0.01), 9.7±1.6( P 0.05) after anesthesia. There was no significant changes in SPO2 and CVP before and after induction. Conclusion: The induction of anesthesia by combination of etomidate- fantanyl may obtain smooth hemodynamics and effectively inhibit cardiovascular reactions caused by tracheal intubation and adverse reactions of etomidate. It`s a good anesthesia inducer for the patients undergoing cardiac valve replacement but with bad cardiac function and in severe condition.