Short-term sevoflurane sedation using the Anaesthetic Conserving Device after cardiothoracic surgery.
OBJECTIVE
We evaluated the procedure of postoperative inhalational sedation with sevoflurane using the Anaesthetic Conserving Device (ACD) with regard to recovery times, feasibility and consumption of anaesthetics in comparison to propofol.


METHODS
Prospective, randomised, single-blinded, controlled study in a surgical intensive care unit (ICU) of a 1,000-bed academic hospital.


METHODS
A total of 70 patients after elective coronary artery bypass graft surgery either received sevoflurane via ACD (n = 35) or propofol (n = 35) for short-term postoperative sedation in the ICU.


RESULTS
The primary endpoint was extubation time from termination of sedation. Recovery times, consumption of anaesthetics, endtidal sevoflurane concentrations, length of ICU and hospital stay, and side effects were documented. Mean recovery times were significantly shorter with sevoflurane than with propofol (extubation time: 22 vs. 151 min; following commands: 7 vs. 42 min). The mean (SD) sevoflurane consumption was 3.2 +/- 1.4 mL/h to obtain mean endtidal concentrations of 0.76 vol%. No serious complications occurred during sedation with either sedative drug. The length of ICU stay was comparable in both groups, but hospital length of stay was significantly shorter in the sevoflurane group. Drug costs (in Euro) for sedation per patient were similar in both groups (sevoflurane: 15.1 +/- 9.5 <euro>; propofol: 12.5 +/- 5.8 <euro>), while sevoflurane sedation costs that included use of the ACD were significantly higher.


CONCLUSIONS
Sevoflurane administration via ACD is an effective and safe alternative to propofol to provide postoperative short-term ICU sedation. Recovery from sedation was facilitated with sevoflurane instead of propofol and resulted in shorter extubation and ventilator times.


BACKGROUND
Neurology/sedation, Sedation and anaesthesia.
Röhm
Kerstin D
KD
Department of Anaesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Bremserstrasse 79, 67063, Ludwigshafen, Germany. k.d.roehm@web.de
Wolf
Michael W
MW
Schöllhorn
Thilo
T
Schellhaass
Alexander
A
Boldt
Joachim
J
Piper
Swen N
SN
D000368:Aged; D000776:Anesthesiology / Q000295:instrumentation*; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D001026:Coronary Artery Bypass; D054810:Deep Sedation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007430:Intraoperative Care; D007902:Length of Stay; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D011184:Postoperative Period; D015742:Propofol; D000077149:Sevoflurane; D016037:Single-Blind Method
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol