OBJECTIVE: We evaluated the procedure of postoperative inhalational sedation with sevoflurane using the Anaesthetic Conserving Device (ACD) with regard to recovery times, feasibility and consumption of anaesthetics in comparison to propofol. DESIGN AND SETTING: Prospective, randomised, single-blinded, controlled study in a surgical intensive care unit (ICU) of a 1,000-bed academic hospital. PATIENTS AND INTERVENTIONS: A total of 70 patients after elective coronary artery bypass graft surgery either receivedsevoflurane via ACD (n = 35) or propofol (n = 35) for short-term postoperative sedation in the ICU. MEASUREMENTS AND MAIN RESULTS: The primary endpoint was extubation time from termination of sedation. Recovery times, consumption of anaesthetics, endtidal sevoflurane concentrations, length of ICU and hospital stay, and side effects were documented. Mean recovery times were significantly shorter with sevoflurane than with propofol (extubation time: 22 vs. 151 min; following commands: 7 vs. 42 min). The mean (SD) sevoflurane consumption was 3.2 +/- 1.4 mL/h to obtain mean endtidal concentrations of 0.76 vol%. No serious complications occurred during sedation with either sedative drug. The length of ICU stay was comparable in both groups, but hospital length of stay was significantly shorter in the sevoflurane group. Drug costs (in Euro) for sedation per patient were similar in both groups (sevoflurane: 15.1 +/- 9.5 <euro>; propofol: 12.5 +/- 5.8 <euro>), while sevoflurane sedation costs that included use of the ACD were significantly higher. CONCLUSIONS:Sevoflurane administration via ACD is an effective and safe alternative to propofol to provide postoperative short-term ICU sedation. Recovery from sedation was facilitated with sevoflurane instead of propofol and resulted in shorter extubation and ventilator times. DESCRIPTOR: Neurology/sedation, Sedation and anaesthesia.
RCT Entities:
OBJECTIVE: We evaluated the procedure of postoperative inhalational sedation with sevoflurane using the Anaesthetic Conserving Device (ACD) with regard to recovery times, feasibility and consumption of anaesthetics in comparison to propofol. DESIGN AND SETTING: Prospective, randomised, single-blinded, controlled study in a surgical intensive care unit (ICU) of a 1,000-bed academic hospital. PATIENTS AND INTERVENTIONS: A total of 70 patients after elective coronary artery bypass graft surgery either received sevoflurane via ACD (n = 35) or propofol (n = 35) for short-term postoperative sedation in the ICU. MEASUREMENTS AND MAIN RESULTS: The primary endpoint was extubation time from termination of sedation. Recovery times, consumption of anaesthetics, endtidal sevoflurane concentrations, length of ICU and hospital stay, and side effects were documented. Mean recovery times were significantly shorter with sevoflurane than with propofol (extubation time: 22 vs. 151 min; following commands: 7 vs. 42 min). The mean (SD) sevoflurane consumption was 3.2 +/- 1.4 mL/h to obtain mean endtidal concentrations of 0.76 vol%. No serious complications occurred during sedation with either sedative drug. The length of ICU stay was comparable in both groups, but hospital length of stay was significantly shorter in the sevoflurane group. Drug costs (in Euro) for sedation per patient were similar in both groups (sevoflurane: 15.1 +/- 9.5 <euro>; propofol: 12.5 +/- 5.8 <euro>), while sevoflurane sedation costs that included use of the ACD were significantly higher. CONCLUSIONS:Sevoflurane administration via ACD is an effective and safe alternative to propofol to provide postoperative short-term ICU sedation. Recovery from sedation was facilitated with sevoflurane instead of propofol and resulted in shorter extubation and ventilator times. DESCRIPTOR: Neurology/sedation, Sedation and anaesthesia.
Authors: Javier F Belda; Marina Soro; Rafael Badenes; Andreas Meiser; María Luisa García; Gerardo Aguilar; Francisco J Martí Journal: Anesth Analg Date: 2008-04 Impact factor: 5.108
Authors: Jörg Martin; Anja Heymann; Katrin Bäsell; Ralf Baron; Rolf Biniek; Hartmut Bürkle; Peter Dall; Christine Dictus; Verena Eggers; Ingolf Eichler; Lothar Engelmann; Lars Garten; Wolfgang Hartl; Ulrike Haase; Ralf Huth; Paul Kessler; Stefan Kleinschmidt; Wolfgang Koppert; Franz-Josef Kretz; Heinz Laubenthal; Guenter Marggraf; Andreas Meiser; Edmund Neugebauer; Ulrike Neuhaus; Christian Putensen; Michael Quintel; Alexander Reske; Bernard Roth; Jens Scholz; Stefan Schröder; Dierk Schreiter; Jürgen Schüttler; Gerhard Schwarzmann; Robert Stingele; Peter Tonner; Philip Tränkle; Rolf Detlef Treede; Tomislav Trupkovic; Michael Tryba; Frank Wappler; Christian Waydhas; Claudia Spies Journal: Ger Med Sci Date: 2010-02-02
Authors: Marc P Steurer; Martina A Steurer; Werner Baulig; Tobias Piegeler; Martin Schläpfer; Donat R Spahn; Volkmar Falk; Pamela Dreessen; Oliver M Theusinger; Edith R Schmid; David Schwartz; Thomas A Neff; Beatrice Beck-Schimmer Journal: Crit Care Date: 2012-10-14 Impact factor: 9.097