Key result
Narcotrend monitoring reduces fentanyl doses and extubation times vs standard care in infant cardiac surgery.
Why the study?
The clinical effectiveness, safety, and feasibility of the Narcotrend monitor for evaluating depth of anesthesia in infants with congenital heart disease undergoing cardiac surgery were not established.
Does Narcotrend monitoring improve hemodynamic stability and reduce anesthetic requirements in infants with congenital heart disease undergoing cardiac surgery?
RCT (n=80)
Randomly assigned
Does Narcotrend monitoring improve hemodynamic stability and reduce anesthetic requirements in infants with congenital heart disease undergoing cardiac surgery?
The use of Narcotrend monitoring in infants undergoing cardiac surgery for congenital heart disease optimizes anesthetic dosing, improves hemodynamic stability, and shortens recovery and extubation times.
Answers are grounded in this paper and cite their sources.
May support Narcotrend for stable hemodynamics and faster recovery in CHD infant surgery; leaves open confirmation in larger trials.
To investigate the clinic effectiveness, safety and feasibility of Narcotrend® monitor for evaluation of depth of anesthesia in congenital heart disease (CHD) infants undergoing cardiac surgery. A total of 80 infants receiving general anesthesia in selective surgery were randomly selected. Infants were assigned into two groups (n = 40 per group). In the Narcotrend group, the depth of anesthesia was monitored with the Narcotrend monitor. In the standard group, the depth of anesthesia was controlled according to the experience. The mean arterial pressure (MAP) and heart rate (HR) were determined, as well as the dose of fentanyl, muscle relaxant, recovery time and extubation time were recorded. In both groups, vital signs were stable during the surgery. When compared with the standard group, the MAP and HR were more stable, the total dose of fentanyl and muscle relaxant were significantly reduced and the recovery time and extubation time were markedly shortened in the Narcotrend group. The application of Narcotrend monitor was beneficial to the control of the depth of anesthesia in CHD infants receiving total intravenous anesthesia, in which small amount of narcotics can achieve optimal anesthesia. Moreover, the recovery time and extubation time are reduced and the harmful consequence such as intraoperative awareness can be avoided. Investigar a eficácia clínica, segurança e viabilidade do monitor Narcotrend® para avaliar a profundidade da anestesia em crianças com doença cardíaca congênita (DCC) submetidas à cirurgia cardíaca. Foram randomicamente selecionadas 80 crianças submetidas à anestesia geral em cirurgia seletiva. As crianças foram divididas em dois grupos de forma aleatória (n = 40 por grupo). No grupo Narcotrend, a profundidade da anestesia foi monitorada com o Narcotrend. No grupo padrão, a profundidade da anestesia foi controlada de acordo com a experiência clínica. A pressão arterial média (PAM) e a frequência cardíaca (FC) foram determinadas e a dose de fentanil e relaxante muscular e os tempos de recuperação e de extubação foram registrados. Em ambos os grupos, os sinais vitais apresentaram-se estáveis durante a cirurgia. No grupo Narcotrend, a PAM e a FC foram mais estáveis, a dose total de fentanil e relaxante muscular significativamente menor e os tempos de recuperação e extubação acentuadamente mais reduzidos em comparação com o grupo padrão. A aplicação do monitor Narcotrend para medir a profundidade da anestesia foi útil para controlar a profundidade da anestesia em crianças com DCC que receberam anestesia intravenosa total, na qual uma pequena quantidade de narcóticos pode obter a anestesia ideal. Além disso, os tempos de recuperação e extubação foram menores e os efeitos secundários, como sensibilização intraoperatória, puderam ser evitados.
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Jiang et al. (2013) conducted an RCT in Congenital heart disease (n=80). Narcotrend monitor vs. Standard clinical experience was evaluated on Mean arterial pressure, heart rate, dose of fentanyl and muscle relaxant, recovery time, and extubation time. The use of the Narcotrend monitor in infants undergoing cardiac surgery significantly reduced fentanyl and muscle relaxant doses, recovery time, and extubation time compared to standard care.
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