Abstract

Caffeine has been shown to enhance the speed of recovery from general anesthesia in murine models, though data in human patients is lacking. This is a retrospective review of intravenous caffeine administration (median dose 150 [125, 250] mg) to 151 heavily sedated patients in the post-anesthesia recovery area, to determine the association between caffeine administration and changes in sedation score, respiratory rate, and oxyhemoglobin saturation. Richmond Agitation-Sedation Scale (RASS) score, respiratory rate, and oxyhemoglobin saturation values were obtained during the 90-minute period prior to and following caffeine administration. Generalized estimating equations (GEE) with explanatory variables of time, caffeine, and the time-by-caffeine interaction were created to assess changes in the variables of interest after caffeine administration. Following the administration of caffeine, the RASS scores increased (estimate = 0.57, SE = 0.14, p < 0.001) but a trend over time or in the interaction effect was not observed, suggesting that the changes in RASS were not solely due to the recovery from anesthesia over time. No association was found between caffeine administration and changes in respiratory parameters. No adverse cardiac events were observed. Our data suggests that intravenous caffeine may enhance the speed of recovery following general anesthesia, though future prospective trials are necessary to define the optimal dose and timing of administration.

Highlights

  • Caffeine, a mild central nervous system stimulant, exerts its effect vis-à-vis antagonism of the adenosine receptors with a resultant increase in dopaminergic activity [1]

  • There was a meaningful trend in respiratory rate (RR) over time, but following caffeine administration there was no increase in the rate or change in the slope, (Figure 1, top panel)

  • This study found an association between the administration of caffeine and an increase in Richmond Agitation-Sedation Scale (RASS) scores in post-surgical patients

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Summary

Introduction

A mild central nervous system stimulant, exerts its effect vis-à-vis antagonism of the adenosine receptors with a resultant increase in dopaminergic activity [1]. In moderate doses, it enhances cognitive function and alertness [2,3]. The aim of this study was to review the Submitted: 14 September 2017/Accepted: 21 November 2017 course of these patients to determine if caffeine administration was associated with improvement in consciousness. This would help determine the feasibility of designing a prospective trial. Because caffeine increases resting ventilation and augments the ventilatory response to hypercapnia and hypoxia [6], a secondary aim of this study was to determine associated changes in respiratory rate (RR) or oxyhemoglobin saturation (SpO2) following caffeine administration

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