Key result
Narcotrend monitoring reduces fentanyl doses and shortens extubation times versus 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)
Randomized
Does Narcotrend monitoring improve hemodynamic stability and reduce anesthetic requirements in infants with congenital heart disease undergoing cardiac surgery?
Narcotrend monitoring in infants undergoing cardiac surgery improves hemodynamic stability, reduces narcotic and muscle relaxant requirements, and shortens recovery and extubation times.
Narcotrend monitoring appears feasible and safe in CHD infants; leaves open outcome benefits 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.
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Jiang et al. (2013) conducted an RCT in Congenital heart disease (n=80). Narcotrend monitor vs. Standard monitoring based on experience was evaluated on Mean arterial pressure, heart rate, dose of fentanyl and muscle relaxant, recovery time, and extubation time. Narcotrend monitoring during cardiac surgery in infants significantly reduced fentanyl and muscle relaxant doses, and shortened recovery and extubation times compared to standard monitoring.
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