TY - JOUR
T1 - A Comparison of Different Remifentanil Effect-Site Concentrations to Allow for Early Extubation After Cardiac Surgery
AU - Khidr, Alaa M.
AU - Khalil, Mohamed A.
AU - Abdulfattah, Dalia
AU - El Tahan, Mohamed R.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/2
Y1 - 2021/2
N2 - Objectives: Assess different remifentanil effect-site concentrations (Ce) for readiness for extubation time after cardiac surgery. Design: Prospective, randomized, blinded, controlled study. Design: Single university hospital. Participants: Seventy-three patients scheduled for cardiac surgery. Interventions: After ethical approval, patients scheduled for cardiac surgery with target-controlled propofol infusion were randomly assigned to receive remifentanil effect-site concentrations (Ce) of 1, 2, or 3 ng/mL (n = 25, 25, and 23, respectively). Measurements and Main Results: The primary endpoint was readiness for extubation. Secondary outcomes were also recorded, including the cumulative doses and number of changes of propofol and remifentanil, hemodynamic variables, time to spontaneous eye opening and breathing, actual extubation, incidences of light anesthesia and myocardial ischemia, need for vasopressors and inotropes, and intensive care unit (ICU) and hospital stays. There was no difference in the time to readiness for extubation in any of the groups (0.1 ng/mL: 11.5 min (5-37); 0.2 ng/mL: 22 min (10-35); and 0.3 ng/mL: 21 min (10-49), p < 0.532); however, there was a significant difference among the 3 groups regarding the cumulative remifentanil doses (p < 0.001). Time to spontaneous eye opening and breathing, actual extubation, use of vasopressors and inotropes, incidences of light anesthesia and myocardial ischemia, and length of ICU and hospital stay were similar for all groups. Forty-six of the 73 patients were extubated on-table. Conclusion: Remifentanil Ce 1, 2, and 3 ng/mL produced comparative effects on time to extubation and hemodynamic responses to cardiac surgery. The 3 Ce resulted in immediate on-table extubation in 50% of patients.
AB - Objectives: Assess different remifentanil effect-site concentrations (Ce) for readiness for extubation time after cardiac surgery. Design: Prospective, randomized, blinded, controlled study. Design: Single university hospital. Participants: Seventy-three patients scheduled for cardiac surgery. Interventions: After ethical approval, patients scheduled for cardiac surgery with target-controlled propofol infusion were randomly assigned to receive remifentanil effect-site concentrations (Ce) of 1, 2, or 3 ng/mL (n = 25, 25, and 23, respectively). Measurements and Main Results: The primary endpoint was readiness for extubation. Secondary outcomes were also recorded, including the cumulative doses and number of changes of propofol and remifentanil, hemodynamic variables, time to spontaneous eye opening and breathing, actual extubation, incidences of light anesthesia and myocardial ischemia, need for vasopressors and inotropes, and intensive care unit (ICU) and hospital stays. There was no difference in the time to readiness for extubation in any of the groups (0.1 ng/mL: 11.5 min (5-37); 0.2 ng/mL: 22 min (10-35); and 0.3 ng/mL: 21 min (10-49), p < 0.532); however, there was a significant difference among the 3 groups regarding the cumulative remifentanil doses (p < 0.001). Time to spontaneous eye opening and breathing, actual extubation, use of vasopressors and inotropes, incidences of light anesthesia and myocardial ischemia, and length of ICU and hospital stay were similar for all groups. Forty-six of the 73 patients were extubated on-table. Conclusion: Remifentanil Ce 1, 2, and 3 ng/mL produced comparative effects on time to extubation and hemodynamic responses to cardiac surgery. The 3 Ce resulted in immediate on-table extubation in 50% of patients.
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U2 - 10.1053/j.jvca.2020.03.049
DO - 10.1053/j.jvca.2020.03.049
M3 - Article
C2 - 32389453
AN - SCOPUS:85084478875
SN - 1053-0770
VL - 35
SP - 470
EP - 481
JO - Journal of cardiothoracic and vascular anesthesia
JF - Journal of cardiothoracic and vascular anesthesia
IS - 2
ER -