الفهرس | Only 14 pages are availabe for public view |
Abstract Fast track cardiac anaesthesia improves patient outcome by decreasing the incidence of postoperative cardiopulmonary complications, reduced intensive care unit (ICU) requirements, shorter ICU and hospital duration of stay and reduces the total costs of cardiac surgery, The safety of IT MAG has been evaluated extensively in animal studies. This study was designed to evaluate the effects of both IT fentanyl and IT fentanyl -magnesium on weaning from CPB, peri-operative analgesic requirements, stress response and the extubation time after elective paediatric cardiac surgery. This study included 80 patients of either sex, aged 4 - 14 years submitted for elective cardiac surgery undergoing cardiopulmonary bypass Patients were randomly classified into 4 groups: (Control group: n = 20) , (ITF (fentanyl) group:n = 20), (IT fentanyl- 0.5 mg/kg magnesium group:n =20) and (IT fentanyl- 1.0mg/kg magnesium group: n =20).The following perioperative data were recorded : Heart rate [H.R], mean arterial blood pressure [MAP], central venous pressure [CVP], end tidal carbon dioxide [EtCO2], peripheral oxygen saturation [SaO2], nasopharyngeal and rectal temperatures, arterial blood gases, total intraoperative I.V. fentanyl used (µg/kg) , aortic cross clamping time (minutes), cardiopulmonary bypass time (minutes), spontaneous recovery of the heart, need for DC shocks and the inotropic and / or vasopressor requirements, objective pain discomfort score, extubation time, the total dose of analgesic consumption , the length of ICU and hospital stays, serum cortisol, and blood glucose. There were no significant differences in the weaning parameters, ICU and hospital length of stays, were found between the four groups, the total of dose intraoperative IV fentanyl used was significantly lower in ITF group, ITFMg (0.5mg) group, and ITFMg(1mg) group when compared with the control groupThe number of patients who were extubated in the operating room was significantly higher in the ITFMg (1mg) group (6 patients) when compared with the other groups.The time to extubation was significantly lower in the ITFMg (1mg) group when compared with the control and ITF groups.There were no significant differences between the four groups in serum cortisol and blood glucose at different stages of evaluation.Postoperative modified objective pain score was significantly lower in the ITFMg (1mg) group in the early postoperative period when compared with the other groups. The mean arterial blood pressure and heart rate was significantly lower in the ITFMg (1mg) group introperatively and early postoperatively when compared with the other groups. |