Early tracheal extubation after paediatric cardiac surgery: the use of propofol to supplement low-dose opioid anaesthesia

Authors: Cray, Steven H.¹; Holtby, Helen M.¹; Kartha, Vyas M.¹; Cox, Peter N.²; Roy, W. Lawrence¹

Source: Paediatric Anaesthesia, Volume 11, Number 4, July 2001 , pp. 465-471(7)

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Abstract:

Background: After institutional approval and parental consent, 103 children, aged 6 months to 18 years, who were undergoing repair of simple and complex congenital heart lesions using cardiopulmonary bypass (CPB) were studied and compared with a group of 135 children who had undergone similar surgery in our institution in the year before.

Methods: Anaesthesia for study patients included fentanyl (< 20 μg·kg⁻¹) and isoflurane. Infusions of propofol (median infusion rate 70 μg·kg⁻¹·min⁻¹) and morphine (median infusion rate 20 μg·kg⁻¹·h⁻¹) were started after weaning from CPB and continued postoperatively. Preestablished criteria were used in the intensive care unit (ICU) to assess readiness for tracheal extubation.

Results: Median time from admission to ICU to tracheal extubation was 5 h. Fifty-six children were extubated within 6 h and 73 within 9 h of ICU admission. Mean ICU stay for study patients was 1.7 days [95% confidence interval (CI) 1.2-2.2] and 2.6 days (95% CI 2.3-2.9) in the comparison group (P<0.005).

Conclusions: We found the propofol regimen to be satisfactory with a shorted ICU stay for these patients.

Keywords: sedation; propofol; intensive care unit: paediatric; heart surgery

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1460-9592.2001.00706.x

Affiliations: 1: Department of Anaesthesia, The Hospital for Sick Children, Toronto, Ontario, Canada 2: Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada

Publication date: 2001-07-01