Key result
Alfentanil and propofol total intravenous anaesthesia achieved effective target plasma concentrations during CABG surgery and allowed for extubation within six hours of sternal closure.
Why the study?
Does alfentanil and propofol total intravenous anaesthesia achieve target plasma concentrations and allow early extubation in patients undergoing CABG with CPB?
Observational (n=25)
Does alfentanil and propofol total intravenous anaesthesia achieve target plasma concentrations and allow early extubation in patients undergoing CABG with CPB?
A manually controlled alfentanil infusion combined with propofol provides effective anesthesia and allows for fast-track recovery and early extubation in patients undergoing CABG.
May enable fast-track extubation after alfentanil-propofol TIVA in CABG; hypothesis-generating and requires prospective trials.
Alfentanil and propofol total intravenous anaesthesia was assessed in 25 patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass (CPB). A manually controlled alfentanil infusion, calculated from estimated lean body mass and published pharmacokinetic data, was effective in achieving target plasma concentrations, while the "Diprifusor" system was used to vary propofol target concentrations according to changes in haemodynamics and anaesthetic requirement. The effects of CPB on alfentanil plasma concentrations were offset by changes in protein binding and free-fraction of the drug. With the use of only two target plasma concentrations for alfentanil (changed after CPB), a pre-determined infusion profile ensured effective plasma concentrations during surgery and concentrations unlikely to inhibit extubation within six hours of sternal closure.
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Blake et al. (2003) conducted an observational in Coronary artery bypass graft surgery with cardiopulmonary bypass (n=25). Alfentanil and propofol total intravenous anaesthesia was evaluated on Target plasma concentrations and extubation time. Alfentanil and propofol total intravenous anaesthesia achieved effective target plasma concentrations during CABG surgery and allowed for extubation within six hours of sternal closure.
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