Lower Dose of Sufentanil Does Not Enhance Fast Track Significantly—A Randomized Study
| Autor: | Carl-Johan Jakobsen, Pia Katarina Ryhammer, Jacob Greisen, Rajesh Bhavsar |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Patient Discharge/trends Sufentanil Airway Extubation/trends 030204 cardiovascular system & hematology Postoperative Care/methods law.invention 03 medical and health sciences 0302 clinical medicine Bolus (medicine) Randomized controlled trial 030202 anesthesiology law Humans Medicine Prospective Studies Prospective cohort study Aged Postoperative Care Pain Postoperative Analgesics Opioid/administration & dosage Dose-Response Relationship Drug business.industry Sufentanil/administration & dosage Perioperative Middle Aged Patient Discharge Analgesics Opioid Anesthesiology and Pain Medicine Pain Postoperative/diagnosis Bispectral index Anesthesia Airway Extubation Anxiety Female medicine.symptom Cardiology and Cardiovascular Medicine business Propofol medicine.drug |
| Zdroj: | Bhavsar, R, Ryhammer, P K, Greisen, J & Jakobsen, C J 2018, ' Lower Dose of Sufentanil Does Not Enhance Fast Track Significantly—A Randomized Study ', Journal of Cardiothoracic and Vascular Anesthesia, vol. 32, no. 2, pp. 731-738 . https://doi.org/10.1053/j.jvca.2017.08.018 |
| ISSN: | 1053-0770 |
| Popis: | Objective: Adjustment in the doses of opioids has been a focus of interest for achieving better fast-track conditions in cardiac anesthesia, but relatively sparse information exists on the potential effect of psychologic and behavioral factors, such as stress, anxiety, and type of personality, on anesthesia requirements and patient turnover in the cardiac recovery unit (CRU); to the authors’ knowledge, this particular focus has not been systematically investigated. In this randomized study, the authors tested the hypothesis that low-dose sufentanil, compared with a standard dose, can improve fast-track parameters and the overall quality of recovery. Opioid requirements related to personality type, pain sensitivity, and preoperative stress and anxiety also were assessed. Design: A randomized, prospective study. Participants: The study comprised 60 patients scheduled for elective coronary artery bypass grafting with or without aortic valve replacement. Setting: A university hospital. Interventions: Patients were randomly assigned to receive either a standard dose (bolus 0.5 µg/kg) or low dose (bolus 0.25 µg/kg) of sufentanil combined with propofol. Measurements and Main Results: The primary outcome variables were ventilation time and eligible time to discharge from the CRU. The secondary objective was to evaluate the relationship between opioid requirements and personality type, pain sensitivity, and preoperative stress and anxiety. The groups were comparable in selected demographics and perioperative parameters. There was no difference between groups in ventilation time (low dose: 191 [163–257] v standard dose: 205 [139–279] min; p = 0.405); eligible CRU discharge time (10.3 ± 5.0 v 10.3 ± 4.2 h; p = 0.978); or administration of postoperative morphine (25 [11-34) v 27 [10–39] g; p = 0.790). There was no difference between groups in total sufentanil administration and various preoperative psychologic and behavioral test levels nor in the time to reach bispectral index |
| Databáze: | OpenAIRE |
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