The efficacy and resource utilization of remifentanil and fentanyl in fast-track coronary artery bypass graft surgery: A prospective randomized, double-blinded controlled, multi-center trial

Davy C H Cheng, Mark F. Newman, Peter Duke, David T. Wong, Barry Finegan, Michael Howie, Jane Fitch, T. Andrew Bowdle, Charles Hogue, Zak Hillel, Eric Pierce, Deo Bukenya

Research output: Contribution to journalArticle

Abstract

We compared (a) the perioperative complications; (b) times to eligibility for, and actual time of the following: extubation, less intense monitoring, intensive care unit (ICU), and hospital discharge; and (c) resource utilization of nursing ratio for patients receiving either a typical fentanyl/isoflurane/propofol regimen or a remifentanil/isoflurane/propofol regimen for fast-track cardiac anesthesia in 304 adults by using a prospective randomized, double-blinded, double-dummy trial. There were no differences in demographic data, or perioperative mortality and morbidity between the two study groups. The minimental status examination at postoperative Days 1 to 3 were similar between the two groups. The eligible and actual times for extubation, less intense monitoring, ICU discharge, and hospital discharge were not significantly different. Further analyses revealed no differences in times for extubation and resource utilization after stratification by preoperative risk scores, age, and country. The nurse/patient ratio was similar between the remifentanil/isoflurane/propofol and fentanyl/isoflurane/propofol groups during the initial ICU phase and less intense monitoring phase. Increasing preoperative risk scores and older age (>70 yr) were associated with longer times until extubation (eligible), ICU discharge (eligible and actual), and hospital discharge (eligible and actual). Times until extubation (eligible and actual) and less intense monitoring (eligible) were significantly shorter in Canadian patients than United States' patients. However, there was no difference in hospital length of stay in Canadian and United States' patients. We conclude that both anesthesia techniques permit early and similar times until tracheal extubation, less intense monitoring, ICU and hospital discharge, and reduced resource utilization after coronary artery bypass graft surgery.

Original languageEnglish (US)
Pages (from-to)1094-1102
Number of pages9
JournalAnesthesia and Analgesia
Volume92
Issue number5
StatePublished - 2001
Externally publishedYes

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Fentanyl
Coronary Artery Bypass
Transplants
Isoflurane
Intensive Care Units
Propofol
Length of Stay
Anesthesia
Airway Extubation
remifentanil
Nursing
Nurses
Demography
Morbidity
Mortality

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

The efficacy and resource utilization of remifentanil and fentanyl in fast-track coronary artery bypass graft surgery : A prospective randomized, double-blinded controlled, multi-center trial. / Cheng, Davy C H; Newman, Mark F.; Duke, Peter; Wong, David T.; Finegan, Barry; Howie, Michael; Fitch, Jane; Bowdle, T. Andrew; Hogue, Charles; Hillel, Zak; Pierce, Eric; Bukenya, Deo.

In: Anesthesia and Analgesia, Vol. 92, No. 5, 2001, p. 1094-1102.

Research output: Contribution to journalArticle

Cheng, DCH, Newman, MF, Duke, P, Wong, DT, Finegan, B, Howie, M, Fitch, J, Bowdle, TA, Hogue, C, Hillel, Z, Pierce, E & Bukenya, D 2001, 'The efficacy and resource utilization of remifentanil and fentanyl in fast-track coronary artery bypass graft surgery: A prospective randomized, double-blinded controlled, multi-center trial', Anesthesia and Analgesia, vol. 92, no. 5, pp. 1094-1102.
Cheng, Davy C H ; Newman, Mark F. ; Duke, Peter ; Wong, David T. ; Finegan, Barry ; Howie, Michael ; Fitch, Jane ; Bowdle, T. Andrew ; Hogue, Charles ; Hillel, Zak ; Pierce, Eric ; Bukenya, Deo. / The efficacy and resource utilization of remifentanil and fentanyl in fast-track coronary artery bypass graft surgery : A prospective randomized, double-blinded controlled, multi-center trial. In: Anesthesia and Analgesia. 2001 ; Vol. 92, No. 5. pp. 1094-1102.
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AU - Wong, David T.

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AU - Howie, Michael

AU - Fitch, Jane

AU - Bowdle, T. Andrew

AU - Hogue, Charles

AU - Hillel, Zak

AU - Pierce, Eric

AU - Bukenya, Deo

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