Which medications in the drug class Opioid Analgesics are used in the treatment of Coronary Artery Bypass Grafting?

Updated: Dec 04, 2019
  • Author: Rohit Shahani, MD, MS, MCh; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Answer

Opioid Analgesics

Induction of anesthesia is accomplished by using high doses of opioid (usually fentanyl or remifentanil) to minimize the dose of propofol, etomidate, or thiopental and thereby maximize cardiovascular stability.

Fentanyl citrate (Duragesic, Abstral, Actiq, Fentora, Onsolis)

Fentanyl citrate is a synthetic opioid that has 75-200 times more potency and a much shorter half-life than morphine sulfate. It has fewer hypotensive effects than morphine and is safer in patients with hyperactive airway disease because of minimal or no associated histamine release. By itself, fentanyl citrate causes little cardiovascular compromise, although the addition of benzodiazepines or other sedatives may result in decreased cardiac output and blood pressure.

Fentanyl citrate is highly lipophilic and protein-bound. Prolonged exposure to it leads to accumulation of the drug in fat and delays the weaning process. Consider continuous infusion because of the medication's short half-life.

Remifentanil (Ultiva)

Remifentanil binds mu-opioid receptors at various sites within the CNS.


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