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Purpose: The purpose of this randomized, double-blind study was to evaluate the efficacy of midazolam and propofol for postoperative sedation and early extubation following cardiac surgery. Methods: ASA physical status II-III patients scheduled to undergo elective first-time cardiac surgery with an ejec'uon fraction > 45% were eligible, All patients received a standardized sufentanilllsoflurane anaesthesia. During cardiopulmonary bypass I00 pg-kg-t.min z propofol was substituted for isoflurane, Upon arnval in the Intensr~e Care Unit (ICU), patients were randomized to either I0 pg.kg-l.min -i propofol (n = 21) or 0.25 pg-kg '.min ' midazolam (n = 20). Infusion rates were adjusted to maintain sedation within a predetermined range (Ramsay 2-4). The infusion was terminated after four hours. Patients were weaned from mechanical ventilation and their tracheas extubated when haemodynarnic stability, haemostasis, normothermia and mental orientation were confirmed. Haemodynamic measurements, arterial blood gas tensions and pulmonary function tests were recorded at specified times. Results: There were no differences between the two groups for the time spent at each level of sedation, number of infusion rate adjustments, amount of analgesic and vasoactive drugs, times to awakening and extubation. The costs of propofol were higher than those of midazolam. There were no differences in haemodynamic values, ar[enal blood gas tensions and pulmonary function. Conclusion: We conclude that midazolam and propofol are safe and effective sedative agents permitting early extubation in this selected cardiac patient population but propofol costs were higher.

P Pu ur rp po os se e: : Magnesium potentiates the effect of nondepolarizing neuromuscular blocking agents. It is used in cardiac anesthesia to prevent hypertension and arrhythmias. This study was performed to measure the interaction between magnesium and cisatracurium in cardiac surgery.

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