Chung-Sik Oh1, Sewon Park1, Seung Wan Hong1, Woon-Seok Kang1, Tae-Gyoon Yoon1, Seong-Hyop Kim2. 1. Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. 2. Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea; Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea. Electronic address: yshkim75@daum.net.
Abstract
OBJECTIVE: To evaluate the effect of two anesthetic agents (sevoflurane or propofol) on postoperative delirium (POD) in patients undergoing off-pump coronary artery bypass grafting (CABG). DESIGN: Retrospective observational design. SETTING:University hospital. PARTICIPANTS: Two hundred ninety-two patients undergoing off-pump CABG who were anesthetized withsevoflurane or propofol. METHODS:Incidence of POD, laboratory data, and pre-, intra-, and 24-hour postoperative clinical variables were reviewed retrospectively. The independent predictors of POD were evaluated. MEASUREMENTS AND MAIN RESULTS: The cumulative incidence of POD after off-pump CABG was 10.6% (31 of 292 patients) and the incidence rates of POD were not statistically significant in the sevoflurane and propofol groups (13% [20 of 156 patients] and 8% [11 of 136 patients], respectively; p = 0.137). Other variables, including the laboratory and clinical data also did not differ significantly between the anesthetic groups. Age ≥75 years (odds ratio [OR], 4.84; 95% confidence interval [CI], 1.44-16.27; p = 0.011), postoperative pneumonia (OR, 10.84; 95% CI, 3.32-35.34; p < 0.001), 6 or more packed red blood cell units transfusion in the first 24 hours postoperatively (OR, 5.30; 95% CI, 1.32-21.27; p = 0.019), and 24-hour postoperative albumin <3.0 g/dL (OR, 3.38; 95% CI, 1.20-9.31; p = 0.021) were independent predictors of POD after off-pump CABG. CONCLUSIONS: The incidence of POD in patients undergoing off pump-CABG did not differ between those receiving sevoflurane versus propofol-based anesthesia.
RCT Entities:
OBJECTIVE: To evaluate the effect of two anesthetic agents (sevoflurane or propofol) on postoperative delirium (POD) in patients undergoing off-pump coronary artery bypass grafting (CABG). DESIGN: Retrospective observational design. SETTING: University hospital. PARTICIPANTS: Two hundred ninety-two patients undergoing off-pump CABG who were anesthetized with sevoflurane or propofol. METHODS: Incidence of POD, laboratory data, and pre-, intra-, and 24-hour postoperative clinical variables were reviewed retrospectively. The independent predictors of POD were evaluated. MEASUREMENTS AND MAIN RESULTS: The cumulative incidence of POD after off-pump CABG was 10.6% (31 of 292 patients) and the incidence rates of POD were not statistically significant in the sevoflurane and propofol groups (13% [20 of 156 patients] and 8% [11 of 136 patients], respectively; p = 0.137). Other variables, including the laboratory and clinical data also did not differ significantly between the anesthetic groups. Age ≥75 years (odds ratio [OR], 4.84; 95% confidence interval [CI], 1.44-16.27; p = 0.011), postoperative pneumonia (OR, 10.84; 95% CI, 3.32-35.34; p < 0.001), 6 or more packed red blood cell units transfusion in the first 24 hours postoperatively (OR, 5.30; 95% CI, 1.32-21.27; p = 0.019), and 24-hour postoperative albumin <3.0 g/dL (OR, 3.38; 95% CI, 1.20-9.31; p = 0.021) were independent predictors of POD after off-pump CABG. CONCLUSIONS: The incidence of POD in patients undergoing off pump-CABG did not differ between those receiving sevoflurane versus propofol-based anesthesia.
Authors: Danielle Greaves; Peter J Psaltis; Daniel H J Davis; Tyler J Ross; Erica S Ghezzi; Amit Lampit; Ashleigh E Smith; Hannah A D Keage Journal: J Am Heart Assoc Date: 2020-11-07 Impact factor: 6.106