Extracorporeal circulation interference on emergence from anesthesia in patients submitted to myocardial revascularization.
OBJECTIVE
Extracorporeal circulation (ECC) may change drug pharmacokinetics as well as brain function. The objectives of this study are to compare emergence time and postoperative sedation intensity assessed by the bispectral index (BIS) and the Ramsay sedation scale in patients undergoing myocardial revascularization (MR) with or without ECC.


METHODS
Ten patients undergoing MR with ECC (ECC group) and 10 with no ECC (no-ECC group) were administered with sufentanyl, propofol 2.0 μg.mL(-1) and pancuronium target controlled infusion. After surgery, propofol infusion was reduced to 1 μg.mL(-1) and suspended when extubation was indicated. Patients BIS, Ramsay scale and time to wake up were assessed.


RESULTS
The ECC group showed lower BIS values beginning at 60 minutes after surgery (no-ECC = 66±13 and ECC = 53±14, p=0.01) until 120 minutes after infusion (no-ECC = 85±8 and ECC = 73±12, p=0.02). Sedation level measured by the Ramsay scale was higher in the ECC group at 30 minutes after the end of the surgery (no-ECC = 5±1 and ECC = 6±0, p=0.021), at the end of infusion (no-ECC = 5±1 and ECC = 6±1, p=0.012) and 5 minutes after the end of infusion (no-ECC = 4±1 and ECC = 5±0.42, p=0.039). Emergence from anesthesia time was higher in the ECC group (no-ECC = 217±81 and ECC = 319±118, p=0.038).


CONCLUSIONS
There was a higher intensity of sedation after the end of surgery and a longer wake up time in ECC group, suggesting changes in the pharmacokinetics of propofol or effects of ECC on central nervous system.
Medical School, Universidade de São Paulo.
Ricardo Antonio Guimarães
RA
Barbosa
Luiz Marcelo Sá
LM
Malbouisson
Luciana Moraes
LM
dos Santos
Marilde de Albuquerque
Mde A
Piccioni
Maria José Carvalho
MJ
Carmona
D000368:Aged; D000762:Anesthesia Recovery Period; D056805:Consciousness Monitors; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization