title: Volatile-based short-term sedation in cardiac surgical patients: a prospective randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the differences in extubation times in a group of cardiac surgical patients who were anesthetized and sedated with either IV propofol or inhaled volatile anesthetic agents.
  
  
  METHODS
  This was a prospective randomized controlled trial performed between September 2009 and August 2011.
  
  
  METHODS
  Cardiovascular ICU within a tertiary referral university-affiliated teaching hospital.
  
  
  METHODS
  One hundred forty-one patients undergoing coronary artery bypass graft surgery with normal or mildly reduced left ventricular systolic function.
  
  
  METHODS
  Participants were randomly assigned to receive anesthesia and postoperative sedation using IV propofol (n = 74) or inhaled volatile (isoflurane or sevoflurane) anesthetic agent (n = 67).
  
  
  RESULTS
  Patients sedated using inhaled volatile agent displayed faster readiness to extubation time at 135 minutes (95-200 min) compared with those receiving IV propofol at 215 minutes (150-280 min) (p < 0.001). Extubation times were faster within the volatile group at 182 minutes (140-255 min) in comparison with propofol group at 291 minutes (210-420 min) (p < 0.001). The volatile group showed a higher prevalence of vasodilatation with hypotension and higher cardiac outputs necessitating greater use of vasoconstrictors. There was no difference in postoperative pain scores, opioid consumption, sedation score, ICU or hospital length of stay, or patient mortality.
  
  
  CONCLUSIONS
  Inhaled volatile anesthesia and sedation facilitates faster extubation times in comparison with IV propofol for patient undergoing coronary artery bypass graft surgery.
authors.affiliation: 1Department Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada. 2Department Anesthesia and Pain Management, Christian Medical College, Vellore, India. 3Divison of Cardiac Surgery, Toronto General Hospital, Toronto, ON, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Jerath
authors.forename: Scott W
authors.initials: SW
authors.lastname: Beattie
authors.forename: Tony
authors.initials: T
authors.lastname: Chandy
authors.forename: Jacek
authors.initials: J
authors.lastname: Karski
authors.forename: George
authors.initials: G
authors.lastname: Djaiani
authors.forename: Vivek
authors.initials: V
authors.lastname: Rao
authors.forename: Terrence
authors.initials: T
authors.lastname: Yau
authors.forename: Marcin
authors.initials: M
authors.lastname: Wasowicz
mesh_terms: D000368:Aged; D060666:Airway Extubation / Q000706:statistics & numerical data*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D015742:Propofol