The effect of sedation on weaning following coronary artery bypass grafting: propofol versus oxycodone‐thiopental

Abstract

Propofol infusion and oxycodone-thiopental bolus dosages, titrated to the same sedation end point, resulted in similar time from admission to extubation, although the weaning period was shorter in the propofol group. In terms of breathing pattern, gas exchange, blood gases and haemodynamics, the methods were similar. Propofol, despite its attractive pharmacological profile, may offer no clinical benefit in short-term sedation after a moderate dose fentanyl anaesthesia in cardiac surgery.

Comparing different postoperative sedation strategies for patients in the intensive care unit after cardiac surgery: A systematic review of randomized controlled trials and network meta‐analysis

“…Among the included studies, nine targeted adult patients after coronary artery bypass graft (CABG), 11,12,31,34,35,37,40,42,43 while the remaining studies included adult patients after CABG, mitral valve replacement, aortic valve replacement 7,32,36 and other targeted cardiac procedures 29,30,33,38,39,41 . For the 13 different sedation and analgesia protocols used, 11 RCTs used propofol, 7,11,12,31–36,39,43 11 used dexmedetomidine, 7,29,30,32,33,36,40–43 3 used sevoflurane, 11,12,34 2 used midazolam, 7,38 2 used dexmedetomidine and ketamine, 37,40 2 used morphine, 29,41 1 used morphine and midazolam, 30 1 used fentanyl, 39 1 used propofol and fentanyl, 39 1 used clonidine, 42 1 used oxycodone‐thiopental, 35 1 used propofol and dexmedetomidine 37 and 1 used propofol and remifentanil 38 . Eight studies used the Richmond agitation and sedation scale (RASS) for sedation assessment to ensure that an appropriate level of sedation was maintained in the ICU for postoperative cardiac patients 7,11,12,30,32,36,39,42 .…”

“…The literature search identified 4719 studies, of which 18 RCTs (N = 1652 patients) fulfilled the inclusion criteria (Figure 1). 7,11,12,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] The details of the PRISMA (version 2020) guidelines used in this study are shown in Table S1. The characteristics of the included studies are reported in Table 1.…”

“…In total, 13 different sedation interventions were used after cardiac surgery in the included studies. Among the included studies, nine targeted adult patients after coronary artery bypass graft (CABG), 11,12,31,34,35,37,40,42,43 while the remaining studies included adult patients after CABG, mitral valve replacement, aortic valve replacement 7,32,36 and other targeted cardiac procedures. 29,30,33,38,39,41 For the 13 different sedation and analgesia protocols used, 11 RCTs used propofol, 7,11,12,[31][32][33][34][35][36]39,43 11 used dexmedetomidine, 7,29,30,32,33,36,[40][41][42][43] 3 used sevoflurane, 11,12,34 2 used midazolam, 7,38 2 used dexmedetomidine and ketamine, 37,40 2 used morphine, 29,41 1 used morphine and midazolam, 30 1 used fentanyl, 39 1 used propofol and fentanyl, 39…”