35763

Fast track anesthesia in off-pump coronary artery bypass (OPCAB) assessment of two anesthetic techniques guided by bispectral index monitoring

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Anesthesiology

Advisors

Abou-El-Futouh, Fawzeya, Hafezh, Huda S., El-Ashmawi, Husam

Authors

Abdel-Munaem, Muhammad Muhammad

Accessioned

2017-03-30 06:22:35

Available

2017-03-30 06:22:35

type

M.D. Thesis

Abstract

Forty patients gave written informed consent for this prospective randomized trial. Patients were scheduled to perform elective coronary artery bypass graft surgery, Off-Pump technique. All patients had good left ventricular function (ejection fraction >50%). Patients were randomly divided into two equal groups I and II (each of 20). Two Fast-track Anesthetic techniques were assessed in this study Guided by BIS monitor. In group I (Propofol group), anesthesia was induced by propofol, 1 mg.kg–1, fentanyl, 5–10 μg.kg–1, and maintained by infusion of both drugs, propofol at 4 mg.kg–1.h–1 and fentanyl at 3–5μg.kg–1.h–1. In group II (Isoflurane group), anesthesia was induced by propofol, 1 mg.kg–1, fentanyl, 5–10 μg.kg–1, and maintained by Isoflurane at MAC 0.5-1 and fentanyl at 3–5μg.kg–1.h–1. Intubation was facilitated by pancuronium, 0.1 mg.kg–1. Doses were adjusted according to the bispectral index monitoring titrating the anesthetics to keep BIS level below 55 in each group. Hemodynamics (SBP, DBP, MAP and HR) were monitored. BIS values, along with hemodynamic parameters were observed throughout the whole operation and tabulated in definite nine times perioperatively, pre-induction, post-induction, after sternotomy, before anastomoses, after anastomoses, after closure of sternotomy, after discontinuation of anesthesia and upon transfer to ICU. Results: Hemodynamic stability was achieved by both techniques using propofol/fentanyl and Isoflurane/fentanyl anesthesia with adequate titration against the BIS values. Propofol produced more hemodynamic stability, mainly toward the end of surgery with more rapid awakening and return to conscious level than Isoflurane, although both provided adequate anesthesia during surgery.

Issued

1 Jan 2003

Details

Type

Thesis

Created At

31 Jan 2023