PROPOFOL - REMIFENTANIL VERSUS MIDAZOLAM - FENTANYL IN CORONARY ARTERY BYPASS GRAFT SURGERY AND INTENSIVE CARE UNIT
Background: In this study, we aim to identify the efficiency of propofol-remifentanil anesthesia in reducing the postoperative intensive-care unit stay in patients undergoing cardiac surgery in our center, without compromising the hemodynamic stability.
Subject and Methods: Two hundred patients undergoing first time elective coronary artery bypass graft surgery were recruited in this single-centered, single-blinded, prospective and controlled study. Study patients were randomized into two treatment groups: group 1 (P-R; Propofol-Remifentanil) (n=100 patients) and group 2 (M-F; Midazolam-Fentanyl) (n=100 Patients). Clinical measurement of Mean arterial blood pressure and heart rate for each patient were recorded before (T1) and after (T2) induction of anesthesia; after sternotomy (T3) and before cardiopulmonary bypass (CPB) (T4). Time from cessation of anesthesia to tracheal extubation was also recorded (T5).
Results: Comparing the hemodynamic parameters between the two groups at T1, T2, T3 and T4 set points revealed statistically significant difference (P < 0.5) in hemodynamic variables in all parameters measured apart from HR at T3. The mean recorded times from cessation of anesthesia to tracheal extubation (T5) were 99.32 minutes and 183.33 minutes in group 1 and 2, respectively. A statistically significant difference was noted between T5 in both groups (P value = 0.003).
Conclusions: Our study has shown that Propofol-Remifentanil anesthesia helps to reduce the time interval between cessation of anesthesia and extubation and, by doing so, it can potentially reduce the postoperative ICU stay, without compromising hemodynamic stability.
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