339: Sanitation of dental foci in cardiac surgery—local or balanced anesthesia

2007 ◽  
Vol 32 (5) ◽  
pp. 181-181
Author(s):  
P JANOUS ◽  
J PODSTATA
Keyword(s):  
Cardiac Surgery ◽  
Balanced Anesthesia ◽  
Dental Foci

scholarly journals Remifentanil-based propofol-supplemented vs. balanced sevoflurane-sufentanil anesthesia regimens on bispectral index recovery after cardiac surgery: a randomized controlled study

2020 ◽  
Vol 15 (4) ◽  
pp. 424-433
Author(s):  
Tae-Yun Sung ◽  
Dong-Kyu Lee ◽  
Jiyon Bang ◽  
Jimin Choi ◽  
Saemi Shin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Primary Outcome ◽  
Postoperative Recovery ◽  
Controlled Study ◽  
Extubation Time ◽  
Balanced Anesthesia ◽  
Effect Site Concentration ◽  
Potential Impact ◽  
The Difference ◽  
Recovery Of Consciousness

Background: The present study was to compare the potential impact of remifentanil-based propofol-supplemented anesthesia regimen vs. conventional sevoflurane-sufentanil balanced anesthesia on postoperative recovery of consciousness indicated by c) values in patients undergoing cardiac surgery.Methods: Patients undergoing cardiac surgery were randomly allocated to get the remifentanil-based propofol-supplemented anesthesia employing target-controlled infusion (TCI) of remifentanil and propofol (Group-PR, n = 15) or a balanced-anesthesia employing sevoflurane-inhalation and TCI-sufentanil (Group-C, n = 19). In Group-PR, plasma concentration (Cp) of TCI-remifentanil was fixed at 20 ng/ml, and the effect-site concentration of TCI-propofol was adjusted within 0.8–2.0 μg/ml to maintain BIS value of 40–60. In Group-C, sevoflurane dosage was adjusted within 1–1.5 minimum alveolar concentration to maintain BIS of 40–60, and Cp of TCI-sufentanil was fixed at 0.4 ng/ml. The inter-group difference in the time for achieving postoperative BIS > 80 (T-BIS80) in the intensive care unit was determined as the primary outcome. The inter-group difference in the extubation time was determined as the secondary outcome.Results: T-BIS80, was shorter in Group-PR than Group-C (121.4 ± 64.9 min vs. 182.9 ± 85.1 min, respectively; the difference of means –61.5 min; 95% CI –115.7 to –7.4 min; effect size 0.812; P = 0.027). The extubation time was shorter in Group-PR than in Group-C (434.7 ± 131.3 min vs. 946.6 ± 393.3 min, respectively, P < 0.001).Conclusions: Compared with the conventional sevoflurane-sufentanil balanced anesthesia, the remifentanil-based propofol-supplemented anesthesia showed significantly faster postoperative conscious recovery in patients undergoing cardiac surgery.

scholarly journals Depth of anesthesia by Narcotrend® and postoperative characteristics in children undergoing cardiac surgery under extracorporeal circulation: a retrospective comparison of two anesthetic regimens

Perfusion ◽  
2020 ◽  
Vol 35 (5) ◽  
pp. 427-435 ◽  
Author(s):  
Konstanze Plaschke ◽  
Anne Weiskircher ◽  
Laura Benner ◽  
Bertold Klein ◽  
Tsvetomir Loukanov ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Total Intravenous Anesthesia ◽  
Depth Of Anesthesia ◽  
Intravenous Anesthesia ◽  
Ventilation Time ◽  
Anesthesia Group ◽  
Balanced Anesthesia ◽  
Postoperative Ventilation

Background: Depth of anesthesia may be insufficient in pediatric cardiac anesthesia if a total intravenous anesthetic regimen with opioids and midazolam is used during cardiopulmonary bypass. The advantages of sevoflurane-based balanced anesthesia may be (1) a more graduated regulation of the depth of anesthesia during cardiopulmonary bypass and (2) a reduction in postoperative ventilation time for children in comparison with total intravenous anesthesia. Aim: To evaluate a possibly positive effect of sevoflurane-based balanced anesthesia in children undergoing cardiac surgery we analyzed whether this anesthetic regimen had a significant effect related to (1) depth of anesthesia, (2) the need for opioids during cardiopulmonary bypass as well as on postoperative characteristics such as (3) time of postoperative ventilation, and (4) duration of stay in the intensive care unit in comparison with total intravenous anesthesia. Methods: In a retrospective analysis, data from heart-lung machine protocols from 2013 to 2016 were compared according to anesthetic regimen (sevoflurane-balanced anesthesia, n = 70 vs. total intravenous anesthesia, n = 65). Children (age: 8 weeks to 14 years) undergoing cardiac surgery with cardiopulmonary bypass were included. As a primary outcome measure, we compared Narcotrend® system–extracted data to detect insufficient phases of anesthetic depth during extracorporeal circulation under moderate hypothermia. Postoperatively, we measured the postoperative ventilation time and the number of days in the intensive care unit. Furthermore, we analyzed patients’ specific characteristics such as opioid consumption during cardiopulmonary bypass. Regression analysis relating primary objectives was done using the following variables: anesthetic regimen, age, severity of illness/surgery, and cumulative dosage of opiates during cardiopulmonary bypass. Results: No significant differences were observed in descriptive patient characteristics (age, body weight, height, and body temperature) between the two groups. Further, no significant differences were found in depth of anesthesia by analyzing phases of superficial B1-C2-electroencephalography Narcotrend® data. No marked difference between the groups was observed for the duration of postoperative intensive care unit stay. However, the postoperative ventilation time (median (95% CI, hours)) was significantly lower in the sevoflurane-based balanced anesthesia group (6.0 (2.0-15.0)) than in the total intravenous anesthesia group (13.5 (7.0-25)). A higher dosage of opioids and midazolam was required in the total intravenous anesthesia group to maintain adequate anesthesia during cardiopulmonary bypass. Regression analysis showed an additional, significant impact of the following factors: severity of illness and severity grade of cardiac surgery (according to Aristotle) on the primary endpoint. Conclusion: In children undergoing cardiac surgery in our department, the use of sevoflurane-balanced anesthesia during cardiopulmonary bypass showed no superiority of inhalational agents over total intravenous anesthesia with opioids and benzodiazepines preventing phases of superficial anesthesia, but a marked advantage for the postoperative ventilation time compared with total intravenous anesthesia.

Nalbuphine as an Analgesic Component in Balanced Anesthesia for Cardiac Surgery

1988 ◽  
Vol 32 (3) ◽  
pp. 158
Author(s):  
E. K. ZSIGMOND ◽  
A. P. WINNIE ◽  
S. M. A. RAZA ◽  
X. Y. WANG ◽  
E. BARABAS
Keyword(s):  
Cardiac Surgery ◽  
Balanced Anesthesia

Nalbuphine as an Analgesic Component in Balanced Anesthesia for Cardiac Surgery

1987 ◽  
Vol 66 (11) ◽  
pp. 1155???1164 ◽  
Author(s):  
Elemer K. Zsigmond ◽  
Alon P. Winnie ◽  
Syed M. A. Raza ◽  
Xiu Y. Wang ◽  
Eva Barabas
Keyword(s):  
Cardiac Surgery ◽  
Balanced Anesthesia

Blood-volume studies in cardiac-surgery patients

JAMA ◽  
1966 ◽  
Vol 195 (5) ◽  
pp. 356-361 ◽  
Author(s):  
J. B. McClenahan
Keyword(s):  
Cardiac Surgery ◽  
Blood Volume
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