Propofol sedation after open heart surgery A clinical and pharmacokinetic study

McMurray, T. J.; Collier, P. S.; Carson, Ian; Lyons, Seán; Elliott, Paul I. P.

doi:10.1111/j.1365-2044.1990.tb14743.x

Cited by 98 publications

(29 citation statements)

References 11 publications

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“…Although most studies have shown little difference between propofol or midazolam as far as cardiovascular changes are concerned, 3,5,6 one study has suggested that there may be a greater hypotensive effect associated with the use of propofol than with midazolam. 12 The lack of difference in these cardiovascular variables between the two groups in our study confirms the majority of earlier studies showing no difference between propofol and midazolam.…”

Section: Propofol Midazolammentioning

confidence: 99%

Propofol or midazolam for short-term alterations in sedation

Boyd

Rushmer

et al. 1993

Can J Anaesth

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It is often necessary to adjust a patient (92,8 -1-35,0 rain, P < 0,05). Aprks la physioth~rapie, le dosage de midazolam n~cessite 1,8 -t-0.5 ajustements comparativement ~ 0,4 + O,2 pour le propofol (P < 0,05). Pendant la physioth~rapie, la posologie du propofol doit ~tre ajustde 3,5 fois comparativement ~ 3,5 pour celle du midazolam (NS) Most patients admitted to intensive care units, who are subsequently ventilated artificially, require some form of sedation during at least part of their stay and it is common practice to use either midazolam or propofol by continuous intravenous infusion. It has been shown t-6 that over a 24-hr period both midazolam and propofol offer good quality of sedation and that the quicker wake up time that is seen with propofol may mean that this agent has benefits over midazolam. These studies, however, CANJ ANAESTH 1993 / 40:12 / pp 1142

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Section: Propofol Midazolammentioning

confidence: 99%

Propofol or midazolam for short-term alterations in sedation

Boyd

Rushmer

et al. 1993

Can J Anaesth

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“…Conscious sedation has been used in many trials during the immediate postoperative period after cardiac surgery and is mostly defined as Ramsay score of 2±4 [15,16,17,18]. Open eyes (Ramsay score 2) disturb the processed EEG, thus a Ramsay score of 4 may be best for testing the efficacy of conscious sedation.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of two processed EEG analyzers for assessment of sedation after coronary artery bypass grafting

2000

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“…However, a recent review of the practice of cardiac anaesthesia with goal-directed objectives has challenged not only the use of intraoperative highdose opioids but also the need for prolonged mechanical ventilation} Indeed, earlier tracheal extubation and discharge from the Intensive Care Unit (ICU) without increased mortality and morbidity and with decreased overall cost have been demonstrated. [2][3][4][5][6] Presently, benzodiazepines are amongst the most common group of drugs used and midazolam has emerged as the agent of choice in several intensive care units because of its pharmacological profile and ease of administration. However, propofol is rapidly gaining popularity since its approval for ICU sedation.…”

mentioning

confidence: 99%

“…2,3,5,7 Comparative studies between propofol and midazolam for sedation of post-cardiac surgery patients have shown that patients treated with propofol can be weaned faster from mechanical ventilation and required less analgesia and adjustment in the infusion rate} -s,7 Unfortunately, none of the previous comparative studies were blinded, all involved prolonged ventilatory support (>12 hr) and none attempted to extubate tracheas early (<6 hr). The differences observed between propofol and midazolam may be related to the prolonged infusion of these agents with different context-sensitive halftimes, s Therefore, this double-blind randomized study was undertaken to determine and compare the effectiveness, safety and dosage requirements of propofol and midazolam for short-term sedation and early extubation following cardiac surgery.…”

mentioning

confidence: 99%

Propofol or midazolam for sedation and early extubation following cardiac surgery

et al. 1997

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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.

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Propofol sedation after open heart surgery A clinical and pharmacokinetic study

Abstract: Summary One hundred a h l t patients who required mechanical ventilation after open heart

Cited by 98 publications

References 11 publications

Propofol or midazolam for short-term alterations in sedation

Propofol or midazolam for short-term alterations in sedation

Evaluation of two processed EEG analyzers for assessment of sedation after coronary artery bypass grafting

Propofol or midazolam for sedation and early extubation following cardiac surgery

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