Kardiyak Cerrahide Konvansiyonel ve Dengeli Anestezi Yönetimlerinin İntraoperatif Hemodinamik Parametreler ve Postoperatif Derlenme Üzerine Etkileri: Gözlemsel Çalışma

Abstract

Objective: Fast-track and balanced anesthesia protocols have been developed in years, in cardiac surgery. Conventional high-dose fentanyl and midazolam techniques lost their popularity because of several known side effects. The primary aim of this study is; to compare traditional and balanced anesthesia protocols in terms of postoperative pain and sedation scales and early extubation criterias. The secondary aim is to observe the effects of these two different anesthesia protocols on intraoperative hemodynamics. Material and Methods: Conventional anesthesia group patients were administered 10 μg kg-1 fentanyl, 0.15 mg kg-1 midazolam as anesthesia induction; 3 μg kg-1 fentanyl and 0.01-0.05 mg kg-1 midazolam as anesthesia maintenance. Balanced anesthesia group patients were administered propofol 2 mg kg-1, ketamine 1 mg kg-1 as anesthesia induction; continuous infusion of remifentanil and sevoflurane as anesthesia maintenance. Patients were evaluated in terms of intraoperative hemodynamic parameters. In addition; pain, sedation, and extubation criteria were evaluated at postoperative 2nd hour. Results: Forty-nine adult patients who underwent coronary surgery were analyzed. Intraoperative hemodynamics were similar in both groups. However, the rates of total nitroglycerine and ephedrine doses were found to be significantly higher in the group conventional (p<0.001, p=0.013). In addition, postoperative sedation scores and the rate of patients who didnot meet extubation criteria were higher in the conventional group (p<0.001). Conclusion: Our balanced anesthesia management protocol seems to provide intraoperative hemodynamic stability, in addition, beter postoperative recovery in coronary surgery patients.