Remifentanil Anesthesia and Postoperative BIS in Cardiac Surgery

• Status: Completed
• Trial end date: 2016-10-01
• Target enrollment: 0
• Participant gender: All

Summary

Background: Although remifentanil based anesthesia has been preferred for fast-track cardiac anesthesia, its recovery profile in cognitive function has not been investigated. Authors determined postoperative Bispectral index (BIS) score as well as extubation time after remifentanil-based propofol-supplemented anesthesia and compared them with those after conventional balanced sevoflurane-sufentanil anesthesia.

Methods: Patients undergoing cardiac surgery using moderate hypothermic cardiopulmonary bypass (CPB) will be randomly allocated to get remifentanil-based propofol-supplemented (Group R) or conventional sevoflurane-sufentanil regimen (Group C) in the study period. For anesthetic induction and maintenance, fixed target controlled infusion (TCI) of remifentanil (plasma concentration 20 ng/ml) and TCI-propofol for maintaining BIS score 40-60 (effect concentration 0.8-1.5 μg/ml) in Group R, and TCI-sufentanil (Cp 0.4- 0.8 ng/ml) and sevoflurane inhalation for maintaining 80-120 % of baseline BP and BIS < 60 (< 1.5 MAC) in Group C, respectively.

Authors will analyze postoperative recovery of cognitive function by using BIS after the use of remifentanil-based propofol-supplemented anesthesia for cardiac surgery and to compare them to those after the use of conventional balanced sevoflurane-sufentanil anesthesia.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Konkuk University Medical Center
• Treatments: Anesthetics; Remifentanil; Sevoflurane; Sufentanil

Criteria

Inclusion Criteria:

1. Patients undergoing cardiac valve repair or replacement surgery under moderate hypothermic cardiopulmonary bypass (CPB).

2. All patients should provide written informed consents

Exclusion Criteria:

Preoperative exclusion criteria

1. urgent or emergent surgery,

2. left ventricle (LV) ejection fraction < 50%,

3. application of intraaortic balloon pump (IABP),

4. myocardial infarction,

5. neurologic deficit,

6. hepatic or renal impairment,

7. pacing,

8. inotropic medication,

9. neurologic deficit.

Intraoperative exclusion criteria

1. CPB application > 250 min,

2. transfused of packed red blood cell (pRBC) > 5 units,

3. post-CPB use of double inotropic support > 30 min ,

4. post-CPB pacing,

5. IABP

6. IABP

7. postoperative hemodialysis,

8. excessive bleeding > 750 ml during postoperative 6 hour,

9. reoperation due to excessive bleeding.