Moderate hypothermia and its effects in reducing the applied dose of anesthetics for patients with opium dependence in cardiac surgery: A randomized controlled trial
Background: An increasing number of patients addicted to opium are experiencing awareness during coronary artery bypass surgery (CABG) as a result of tolerance to anesthetics. Objectives: This research was primarily intended to determine the potential diminishing effects of moderate hypothermia o...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Electronic Physician
2016-09-01
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| Series: | Electronic Physician |
| Subjects: | |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074762/ |
| Summary: | Background: An increasing number of patients addicted to opium are experiencing awareness during coronary
artery bypass surgery (CABG) as a result of tolerance to anesthetics.
Objectives: This research was primarily intended to determine the potential diminishing effects of moderate
hypothermia on anesthetic dosage and recall of anesthesia during the procedure.
Methods: In this double-blind randomized controlled trial, a total of 80 CABG candidates with known addiction
to opium were divided into two groups: one normothermic (N) and the other moderately hypothermic (H), both
undergoing induction as well as close monitoring from September 2014 to January 2016. The candidates were
initially set for a target bispectral index (BIS) score of between 40 and 60. As the score rose to 60, an additional
dose of propofol was administered, alongside rise in blood pressure and tear-shedding. To enhance the accuracy
of our evaluation of anesthetic depth, we also used two questionnaires to test candidates’ recall filled with the
assistance of a colleague 24 hours following surgery. Independent-samples t-test and chi-square test were used by
SPSS v 18 for data analysis.
Results: Eighty patients were studied in two groups of normothermic (N) (n = 40) and hypothermic (H) (n = 40).
Given similar demographic data as well as the duration of surgery, we arrived at a propofol dose of 122.52±13.11
cc for normothermic patients and 101.28±14.06 cc for hypothermic subjects (p=0.001). As for fentanyl, the total
required sum came up to 39.60±21.04 cc and 31.72±5.81 cc for the above-mentioned groups in order (p=0.025).
Moreover, the post-operative interview showed that there was no report of a patient with memory recall following
surgery.
Conclusions: Moderate hypothermia can substantially reduce the need for anesthetics in patients with addiction
to opium when undergoing CABG surgery.
Trial registration: This study is registered in Iranian Registry of Clinical Trials with registration number of
IRCT2014050513159N5.
Funding: This research was supported financially by the Research Council of Mashhad University of Medical
Sciences (grant number 920405). |
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| ISSN: | 2008-5842 2008-5842 |