Journal article
A Comparison of Different Remifentanil Effect-Site Concentrations to Allow for Early Extubation After Cardiac Surgery


Research Areas
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Publication Details
Author list: Alaa M. Khidr, Mohamed A. Khalil, Dalia Abdulfattah and Mohamed R. El Tahan
Publisher: WB Saunders
Publication year: 2021
Journal: Journal of Cardiothoracic and Vascular Anesthesia
Journal name in source: Journal of cardiothoracic and vascular anesthesia
Volume number: 35
Issue number: 2
Start page: 470
End page: 481
Number of pages: 12
ISSN: 1053-0770
Web of Science ID: 000601039600020
PubMed ID: 32389453
Scopus ID: 85084478875
eISSN: 1532-8422


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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Last updated on 2021-01-02 at 15:30