A randomized double-blinded multicenter comparison of remifentanil versus fentanyl when combined with isoflurane/propofol for early extubation in coronary artery bypass graft surgery

Anesthesia and Analgesia
M B HowieD Bukenya

Abstract

We compared a fentanyl/isoflurane/propofol regimen with a remifentanil/isoflurane/propofol regimen for fast-track cardiac anesthesia in a prospective, randomized, double-blinded study on patients undergoing elective coronary artery bypass graft surgery. Anesthesia was induced with a 1-min infusion of 0.5 mg/kg propofol followed by 10-mg boluses of propofol every 30 s until loss of consciousness. After 0.2 mg/kg cisatracurium, a blinded continuous infusion of remifentanil at 1 microg. kg(-1). min(-1) or the equivalent volume rate of normal saline was then started. In addition, a blinded bolus syringe of 1 microg/kg remifentanil or 10 microg/kg fentanyl, respectively, was given over 3 min. Blinded remifentanil, 1 microg. kg(-1). min(-1) (or the equivalent volume rate of normal saline), together with 0.5% isoflurane, were used to maintain anesthesia. Significantly more patients (P < 0.01) in the fentanyl regimen experienced hypertension during skin incision and maximum sternal spread compared with patients in the remifentanil regimen. There were no differences between the groups in time until extubation, discharge from the surgical intensive care unit, ST segment and other electrocardiogram changes, catecholamine levels, or cardia...Continue Reading

References

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Citations

Mar 27, 2010·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Ghislaine A P G van MastrigtJos G Maessen
Sep 7, 2012·Interactive Cardiovascular and Thoracic Surgery·Marco C HaanschotenMohamed A Soliman Hamad
May 31, 2015·Journal of Cardiothoracic and Vascular Anesthesia·Michael G Irwin, Gordon Tin Chun Wong
Aug 16, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Janet Martin, Davy Cheng
May 1, 2009·Korean journal of anesthesiology·Tae Hun KimJun Heum Yon
Apr 28, 2004·Anesthesiology·Alexandre OuattaraPierre Coriat
Nov 10, 2007·Anaesthesia·R KomatsuC C Apfel
Jan 18, 2011·Anesthesiology·Vesna SvircevicDiederik van Dijk
Apr 23, 2005·Anesthesia and Analgesia·Gregory B HammerDavid R Drover
Feb 20, 2009·Anesthesia and Analgesia·Vesna SvircevicDiederik van Dijk
Mar 11, 2006·Drugs·Anna J Battershill, Gillian M Keating
Nov 21, 2017·Turkish Journal of Medical Sciences·Mediha TürktanAtakan Atalay
Sep 12, 2018·International Anesthesiology Clinics·Eric J P ChanowskiDaryl A Oakes
Apr 27, 2001·Anesthesia and Analgesia·P Coriat, M Beaussier
Jan 9, 2010·Journal of Cardiothoracic and Vascular Anesthesia·Gordon T C WongMichael G Irwin
Sep 14, 2007·Veterinary Anaesthesia and Analgesia·Sandra AllweilerHatim I K Alibhai
Sep 21, 2010·Journal of Cardiothoracic and Vascular Anesthesia·William C OliverMartin D Abel

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