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Epidural Anesthesia and Postoperative Analgesia With Ropivacaine and Fentanyl

Not Applicable
Completed
Conditions
Coronary Artery Disease
Registration Number
NCT01384175
Lead Sponsor
Northern State Medical University
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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
93
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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Duration of postoperative mechanical ventilationParticipants will be followed for the duration of mechanical ventilation, an expected average of 6 hours

Duration of postoperative mechanical ventilation, hours

Secondary Outcome Measures
NameTimeMethod
Hemodynamic stabilityAll period of operation and during 24 hours postoperatively

Hemodynamic stability as assessed by mean arterial pressure, heart rate, cardiac index, requirement of inotrops/vasoactives and colloids

Trial Locations

Locations (1)

Dep. of Anesthesiology, Northern SMU

🇷🇺

Arkhangelsk, Russian Federation

Dep. of Anesthesiology, Northern SMU
🇷🇺Arkhangelsk, Russian Federation

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