Opioid Reduced Anesthesia With Parasternal CATheters on Postoperative Delirium After Cardiac Surgery
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Cardiac Disease
- Sponsor
- Centre Hospitalier Universitaire de Saint Etienne
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Number of Postoperative delirium (POD) assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in the first 48 hours after surgery
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
PostOperative Delirium (POD) is the most common neuropsychiatric complication following cardiac surgery and may be related to morphine consumption. PostOperative Delirium (POD) prolongs hospital and intensive care unit (ICU) length of stay (LOS) and increases morbidity and mortality. No study has been conducted to demonstrate the effect of regional anesthesia using catheters inserted before sternotomy.
Detailed Description
This study investigate the effect of an enhanced recovery protocol using regional anesthesia on PostOperative Delirium (POD) onset.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age over 18
- •Admitte for scheduled cardiac surgery with sternotomy under cardiopulmonary bypass (CPB) for coronary artery bypass grafting (CABG), surgical correction of valve disease (aortic, mitral or tricuspid) or combined surgery (coronary artery bypass grafting (CABG) and valve replacement).
Exclusion Criteria
- •Age over 85,
- •emergency surgery or heart transplant,
- •body mass index (BMI) more than 40 kg.m-2
- •reoperation
- •Renal insufficiency with glomerular filtration rate (GFR) less than 30 mL.min-1
- •left ventricular ejection fraction less than 30%
- •respiratory insufficiency with arterial pressure of oxygen less than 60 mmHg
- •hepatic insufficiency with prothrombin rate less than 30% or cirrhosis
- •chronic hyperglycemia not controlled
- •pregnancy
Outcomes
Primary Outcomes
Number of Postoperative delirium (POD) assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in the first 48 hours after surgery
Time Frame: Hours: 48
assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Delirium is diagnosed when criteria 1 and 2 are positive, as well as criteria 3 or 4.
Secondary Outcomes
- Number of hypoxemia postoperative in the first 48 hours after extubation(Hours: 48)
- Total morphine consumption within 48h after extubation(Hours: 48)
- Pain at 24 hours and 48 hours postoperative(Hours: 24, 48)
- postoperative nausea and vomiting(Hours: 48)
- major complications (neurological, respiratory, cardiac, infectious)(Hours: 48)
- Number of Ileus postoperative in the first 48 hours after extubation(Hours: 48)
- mortality at 30 days after surgery(Day: 30)