Early extubation after mitral valve surgery: A target-controlled infusion of propofol and low-dose sufentanil

D’Attellis, Nicola; Nicolas-Robin, Arrnelle; Delayance, S.; Carpentier, Alain; Baron, J. F.

doi:10.1016/s1053-0770(97)90057-4

Cited by 24 publications

(8 citation statements)

References 41 publications

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“…[1][2] The use of volatile anesthetics or iv propofol in combination with low-dose or short-acting opioids (fentanyl, alfentanil, remifentanil) [3][4] results in early extubation but requires supplemental analgesia in the early postoperative period with frequent patient discomfort or respiratory depression. The use of perioperative epidural anesthesia and analgesia allows intense postoperative analgesia, stress-response attenuation and thoracic cardiac sympathectomy with possible reduction of the risk of myocardial ischemia.…”

Section: [L'administration Intrathécale Combinée De Sufentanil-morphimentioning

confidence: 99%

“…A two-hour sedation score using the Ramsay scale 11 and a four-hour analgesic score [visual analogue scale (VAS), [1][2][3][4][5][6][7][8][9][10] was recorded by the nurses in the ICU. Patients were questioned regarding the occurrence of pruritus, nausea and vomiting as well as intraoperative awareness.…”

Section: Postoperative Managementmentioning

confidence: 99%

“…D Di is sc cu us ss si io on n Our data suggest that in low-risk patients undergoing CABG or valve surgery without contraindication to locoregional anesthesia, combined IT sufentanil and morphine with TCI-propofol allows a shorter postoperative duration of intubation, adequate analgesia and better maximal inspiratory capacity as compared with a standard iv anesthetic technique. 3 Choice and advantages of the method used Recent evidence suggests that fast-track cardiac surgery is not only safe but may improve patient outcome by decreasing the incidence of postoperative cardiopulmonary morbidity and may lower the cost of cardiac surgery. [1][2][3]9 The optimal anesthetic technique to reach this goal remains debatable.…”

Section: Extubation Postoperative Analgesia and Complicationsmentioning

confidence: 99%

“…3 Choice and advantages of the method used Recent evidence suggests that fast-track cardiac surgery is not only safe but may improve patient outcome by decreasing the incidence of postoperative cardiopulmonary morbidity and may lower the cost of cardiac surgery. [1][2][3]9 The optimal anesthetic technique to reach this goal remains debatable. TCI-propofol offers stable hemodynamics with minimal negative inotropism and a rapid and controlled recovery; it is widely used for noncardiac as well as cardiac surgery.…”

Section: Extubation Postoperative Analgesia and Complicationsmentioning

confidence: 99%

“…TCI-propofol offers stable hemodynamics with minimal negative inotropism and a rapid and controlled recovery; it is widely used for noncardiac as well as cardiac surgery. 15 Because of its previously demonstrated advantages for fast-track cardiac surgery, 3 we chose TCI-propofol for induction and maintenance of anesthesia.…”

Section: Extubation Postoperative Analgesia and Complicationsmentioning

confidence: 99%

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Intrathecal sufentanil-morphine shortens the duration of intubation and improves analgesia in fasttrack cardiac surgery

Béttex

Schmidlin

Chassot

et al. 2002

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To compare the effect of combined intrathecal morphine and sufentanil with low-dose iv sufentanil during propofol anesthesia for fast-track cardiac surgery.M Me et th ho od ds s: : Twenty-four consecutive patients with normal cardiopulmonary function who were scheduled for elective cardiac surgery were randomized to receive either a continuous iv infusion of sufentanil 0.9 to 1.8 µg·kg -1 ·min -1 (13 patients), or a single lumbar intrathecal dose of sufentanil 50 µg and morphine 500 µg (11 patients). We prospectively studied perioperative analgesia, time to extubation and early postoperative maximal inspiratory capacity in the two groups. In the intensive care unit, the medical and nursing staff were blinded to the analgesic technique.R Re es su ul lt ts s: : Intrathecal sufentanil morphine allowed a shorter duration of intubation (104 ± 56.5 min vs 213 ± 104 min; P = 0.01), reduced the need for postoperative analgesia with nicomorphine (equipotent to morphine) (0.7 ± 0.4 mg·hr -1 vs 1.2 ± 0.4 mg·hr -1 ; P = 0.008) and improved postoperative maximal inspiratory capacity (53.4 ± 16.1 vs 38.4 ± 12.5% of the norm; P = 0.05).C Co on nc cl lu us si io on n: : In low-risk patients undergoing coronary artery bypass graft or valve surgery, combined intrathecal sufentanil and morphine with a target-controlled infusion of propofol satisfies the goals of fast-track cardiac surgery. (0,7 ± 0,4 mg·h -1 vs 1,2 ± 0,4 mg·h -1 ; P = 0,008) et une amélioration de la capacité inspiratoire maximale postopératoire (53,4 ± 16,1 vs 38,4 ± 12,5 % de la norme ; P = 0,05 AST-TRACK cardiac surgery entails early postoperative extubation with intense control of pain and rapid transfer to the ward and is mostly applied to patients who have well-preserved pulmonary and ventricular function. C Ca ar rd di io ot th ho or ra ac ci ic c A An ne es st th he es si ia a, , R Re es sp pi ir ra at ti io on n a an nd d A Ai ir rw wa ay y

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