Epidural Anesthesia and Postoperative Analgesia With Ropivacaine and Fentanyl in Off-pump Coronary Artery Bypass Grafting
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Coronary Artery Disease
- Sponsor
- Northern State Medical University
- Enrollment
- 93
- Locations
- 1
- Primary Endpoint
- Duration of postoperative mechanical ventilation
- Status
- Completed
- Last Updated
- 14 years ago
Overview
Brief Summary
The aim of the present study was to assess the efficacy of thoracic epidural anesthesia followed by postoperative epidural infusion and patient-controlled epidural analgesia with ropivacaine/fentanyl in off-pump coronary artery bypass grafting
Detailed Description
Ninety-three patients were scheduled for off-pump coronary artery bypass (OPCAB) under propofol/fentanyl anesthesia. Day before surgery patients were asked for informed consent and randomized into three postoperative analgesia regimens aiming at a visual analog scale (VAS) score \<30 mm at rest. The control group (n=31) received intravenous fentanyl 10 µg/ml postoperatively 3-8 mL/h. After placement of an epidural catheter at the level of Th2-Th4 before OPCAB, a thoracic epidural infusion (EI) group (n=31) received epidural anesthesia (EA) intraoperatively with ropivacaine 0.75% 1 mg/kg and fentanyl 1 µg/kg followed by continuous EI of ropivacaine 0.2% 3-8 mL/h and fentanyl 2 µg/mL postoperatively. The patient-controlled epidural analgesia (PCEA) group (n=31), in addition to EA and EI, received PCEA (ropivacaine/fentanyl bolus 1 mL, lock-out interval 12 min) postoperatively. Hemodynamics and blood gases were measured throughout 24 h after OPCAB.
Investigators
Eligibility Criteria
Inclusion Criteria
- •presence of coronary artery disease
- •ASA II-III
- •elective off-pump coronary artery bypass
Exclusion Criteria
- •age \< 18 years
- •severe valve dysfunction or peripheral vascular disease
- •simultaneous interventions (carotid endarterectomy, aneurysm repair, etc.)
- •transfer to CPB during surgery
Outcomes
Primary Outcomes
Duration of postoperative mechanical ventilation
Time Frame: Participants will be followed for the duration of mechanical ventilation, an expected average of 6 hours
Duration of postoperative mechanical ventilation, hours
Secondary Outcomes
- Hemodynamic stability(All period of operation and during 24 hours postoperatively)