The effectiveness and safety of precision cardiac anesthesia in patients undergoing cardiac surgery

Abstract

Objective To investigate the effectiveness and safety of precision cardiac anesthesia. Methods A total of eighty subjects[New York Heart Association(NYHA) grades Ⅰ-Ⅳ] undergoing selective cardiac surgery were enrolled. They were randomly divided into two groups (n=40): a precision cardiac anesthesia group (group P) and a conventional cardiac anesthesia group (group C). Group P was primarily administrated with a low-dose of sufentanil, in combination with target - controlled infusion to accurately adjust the blood concentration of anesthetics as well as bispectral index to monitor anesthesia depth. The aim of this protocol of precision cardiac anesthesia was to achieve the rationalization of anesthetic use. The timing of tracheal extubation following cardiac surgery was determined by pre- and intra-operative individual general condition in group P. Routine dosage sufentanil was traditionally administrated in group C, and patients were transferred to intensive care unit (ICU) with tracheal intubation after surgery. All patients′ data were recorded including baseline characteristics, intraoperative sufentanil dosage, cases with cardiopulmonary bypass(CPB), operation time, lowest temperature, duration of mechanical ventilation, poor events, ICU length of stay, post - operative hospitalization stay and cost of hospital care. Results The total amount of sufentanil used intra-operatively was significantly less in group P than that in group C (P<0.05). The number of patients developing pneumonia after surgery in group C was revealed to be significantly greater than that in group P (P<0.05). Compared to group C, patients in group P had significantly decreased length of mechanical ventilation, ICU stay and post - operative hospital stay (P<0.05). Both total hospital expenditure and medical examination fee were significantly less in group P (P<0.05). Conclusions Precision cardiac anesthesia is of effectiveness and safety in adults undergoing cardiac surgery. It can reduce ICU and post-operative hospitalization stay. It is beneficial to cut the cost of health care, so as to improve efficiency of medical resources. Key words: Cardiac surgery; Precision cardiac anesthesia; Fast track