Anesthesia Standard Operating Procedure During On-pump Coronary Artery Bypass Grafting
Status:
Active, not recruiting
Trial end date:
2022-12-01
Target enrollment:
Participant gender:
Summary
Background: Despite improvements in surgical and anesthesia procedures over the past 15 years
complications during cardiac surgery still remain high. Bridgewater B et al. describes
mortality during on-pump coronary artery bypass grafting (CABG) at 2%-3%, and the rate
postoperative complications about 20%-30%. At the same time, the standard of care in patients
undergoingon-pump CABG is not fully established.
Hypothesis, Research Need: Use of multimodal low-dose opioid anesthesia during CABG decreases
inflammatory response and the incidence of early postoperative cardiac complications due to a
reduction in interleukin-6.
Methodology: According to anesthesia standard protocol, all patients were divided into two
groups - study group with multimodal low-dose opioid anesthesia (60 patients) and control
group with a high-dose opioid anesthesia (60 patients). Primary (IL-6 at the end of the
operation) and secondary clinical outcomes (postoperative atrial fibrillation (POAF), low
cardiac output syndrome (LCOS), duration of mechanical ventilation (MV), length of intensive
care unit (ICU) stay, length of hospital stay) were compared between the groups.
Analysis Tools: Clinical observations; instrumental research methods (electrocapdiography,
echocardiography); labs (blood gases, hemoglobin, electrolytes); enzyme-linked immunosorbent
assay (IL-6); statistical (Student's t-test, Mann-Whitney U test, χ2-test, correlation
analysis).
Expected Outcomes: Use of multimodal low-dose opioid anesthesia during CABG will decrease
inflammatory response (lower levels of IL-6 at the end of the surgery) and the incidence of
early postoperative cardiac complications, expressed as lower incidence of LCOS and POAF,
lower duration of MV and lower length of ICU stay.