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Volatile versus propofol sedation after cardiac valve surgery: a single-center prospective randomized controlled trial.
Flinspach, Armin Niklas; Raimann, Florian Jürgen; Kaiser, Philipp; Pfaff, Michaela; Zacharowski, Kai; Neef, Vanessa; Adam, Elisabeth Hannah.
Afiliación
  • Flinspach AN; Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany. Flinspach@med.uni-frankfurt.de.
  • Raimann FJ; Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany.
  • Kaiser P; Department of Cardiothoracic Surgery, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt am Main, Germany.
  • Pfaff M; Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany.
  • Zacharowski K; Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany.
  • Neef V; Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany.
  • Adam EH; Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany.
Crit Care ; 28(1): 111, 2024 04 05.
Article en En | MEDLINE | ID: mdl-38581030
ABSTRACT

BACKGROUND:

Optimal intensive care of patients undergoing valve surgery is a complex balancing act between sedation for monitoring and timely postoperative awakening. It remains unclear, if these requirements can be fulfilled by volatile sedations in intensive care medicine in an efficient manner. Therefore, this study aimed to assess the time to extubation and secondary the workload required.

METHODS:

We conducted a prospective randomized single-center trial at a tertiary university hospital to evaluate the postoperative management of open valve surgery patients. The study was randomized with regard to the use of volatile sedation compared to propofol sedation. Sedation was discontinued 60 min after admission for critical postoperative monitoring.

RESULTS:

We observed a significantly earlier extubation (91 ± 39 min vs. 167 ± 77 min; p < 0.001), eye-opening (86 ± 28 min vs. 151 ± 71 min; p < 0.001) and command compliance (93 ± 38 min vs. 164 ± 75 min; p < 0.001) using volatile sedation, which in turn was associated with a significantly increased workload of a median of 956 min (± 416 min) set-up time. We did not observe any differences in complications. Cardiopulmonary bypass time did not differ between the groups 101 (IQR 81; 113) versus 112 (IQR 79; 136) minutes p = 0.36.

CONCLUSIONS:

Using volatile sedation is associated with few minutes additional workload in assembling and enables a significantly accelerated evaluation of vulnerable patient groups. Volatile sedation has considerable advantages and emerges as a safe sedation technique in our vulnerable study population. TRIAL REGISTRATION Clinical trials registration (NCT04958668) was completed on 1 July 2021.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propofol / Procedimientos Quirúrgicos Cardíacos Límite: Humans Idioma: En Revista: Crit Care Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propofol / Procedimientos Quirúrgicos Cardíacos Límite: Humans Idioma: En Revista: Crit Care Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido