اكستوباسيون سريع بعد از عمل جراحي پيوند عروق كرونر با پروپوفول و مقايسه آن باميدازولام

Early Extubation Following Coronary Artery Bypass Graft Surgery Protocol Versus Midazolam

Background and Objectives: Rapid recovery involving early extubation and mobility, decreased duration of ICU stay, and decreased duration of hospitalization has recently become an interesting issue in cardiac surgery. The purpose of this randomized clinical trail study was to evaluate the efficacy of propofol versus midazolam on recovery characteristics such as eye-opening, response to verbal stimulation, tracheal extubation, length of ICU stay after coronary artery bypass graft surgery (CABG). Materials and Methods: One hundred patients that scheduled For elective CABG-surgery entered into the study. Fifty patients induced with propofol 1.5 mg/Kg, fentanyl 7 mcg/kg. pancuronium 0.1 mg/kg and 50 patients with midazolam 0.2 mg/Kg, fentanyl 7 meglkg, pancuronium 0.1 mg/kg. Anesthesia was maintained with Propofol 2 mg/Kg-1h versus midazolam 0.1 tng Kg/h before cardio pulmonary bypass and pancuronium, fentanyl halothane were used in both groups with the same doses. Results: Patients receiving propofol were extubated earlier (mean 492 min vs. 696 min p=0.041) with earlier eye opening (162 min vs.215 min p-0.019). earlier response to verbal stimuli (210 min vs.325 min p-0.031) and ICU stay (33h vs.43 It p=0.021). llemodynamic changes were similar in both groups and the use of inotrops and nitroglycerin and the incidence of myocardial ischemia and myocardial infarction were similar. Conclusion: The results of this study highlight the ability to fast-track recovery in patients receiving propofol based anesthesia in CAE3G surgery with earlier recovery and extubation in ICU and lower length of ICU stay than traditional method of midazolam based anesthesia without hemodynamic and ischemic adverse effects.