Early tracheal extubation after paediatric cardiac surgery: the use of propofol to supplement low-dose opioid anaesthesia

Paediatr Anaesth. 2001 Jul;11(4):465-71. doi: 10.1046/j.1460-9592.2001.00706.x.

Abstract

Background: After institutional approval and parental consent, 103 children, aged 6 months to 18 years, who were undergoing repair of simple and complex congenital heart lesions using cardiopulmonary bypass (CPB) were studied and compared with a group of 135 children who had undergone similar surgery in our institution in the year before.

Methods: Anaesthesia for study patients included fentanyl (< 20 microg.kg-1) and isoflurane. Infusions of propofol (median infusion rate 70 microg.kg-1.min-1) and morphine (median infusion rate 20 microg.kg-1.h-1) were started after weaning from CPB and continued postoperatively. Preestablished criteria were used in the intensive care unit (ICU) to assess readiness for tracheal extubation.

Results: Median time from admission to ICU to tracheal extubation was 5 h. Fifty-six children were extubated within 6 h and 73 within 9 h of ICU admission. Mean ICU stay for study patients was 1.7 days [95% confidence interval (CI) 1.2-2.2] and 2.6 days (95% CI 2.3-2.9) in the comparison group (P<0.005).

Conclusions: We found the propofol regimen to be satisfactory with a shorted ICU stay for these patients.

MeSH terms

  • Adolescent
  • Analgesics, Opioid*
  • Anesthetics, Combined*
  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Child
  • Child, Preschool
  • Fentanyl
  • Heart Defects, Congenital / surgery*
  • Humans
  • Hypnotics and Sedatives*
  • Infant
  • Intensive Care Units, Pediatric
  • Intubation, Intratracheal*
  • Isoflurane
  • Morphine
  • Propofol*

Substances

  • Analgesics, Opioid
  • Anesthetics, Combined
  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Hypnotics and Sedatives
  • Morphine
  • Isoflurane
  • Fentanyl
  • Propofol