The effect of ultra-fast track cardiac anaesthesia in infants and toddlers: a randomised trial

Cardiol Young. 2022 Jul;32(7):1092-1097. doi: 10.1017/S1047951121003681. Epub 2021 Sep 8.

Abstract

Background: The usefulness of ultra-fast track cardiac anaesthesia may give great benefits to patients; however, its usefulness has not been completely evaluated in infants and toddlers, who are generally considered the most difficult group for ultra-fast track cardiac anaesthesia.

Method: A total of 130 children were allocated randomly into to a ultra-fast track cardiac anaesthesia group (Group D) or a conventional anaesthesia group (Group C) (each n = 65). In Group D, dexmedetomidine was administrated at a dosage of 1 µg/kg/hour after induction. The patient- controlled intravenous analgesia was dexmedetomidine and sufentanil. In Group C, patients were infused with of the same volume of normal saline, and sufentanil alone for patient-controlled intravenous analgesia. The dosages of sufentanil, extubation time, haemodynamic parameters, postoperative hospitalisation conditions, pain and sedation scores, blood gas analysis, and inotropic scores were all recorded.

Results: The dosage of sufentanil (1.49 ± 0.05 vs. 3.81 ± 0.04 µg, p < 0.001) and extubation time (2.63 ± 0.52 vs. 436.60 ± 22.19 minutes, p < 0.001) in Group D were all significantly lower than those in Group C. Moreover, cardiac intensive care unit stay time, total hospital stay, hospitalisation costs, postoperative lactate levels, and inotropic scores were also significantly lower in Group D.

Conclusions: Using of ultra-fast track cardiac anaesthesia in infants and toddlers is effective, it not only reduce the perioperative requirement for opioids and shorten the extubation time but also decreases the inotrope requirement and provide a better postoperative condition for young children.

Keywords: CHD; Ultra-fast track cardiac anaesthesia; dexmedetomidine; infants; sufentanil; toddlers.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anesthesia*
  • Anesthesia, Cardiac Procedures*
  • Child, Preschool
  • Dexmedetomidine*
  • Humans
  • Length of Stay
  • Pain, Postoperative
  • Sufentanil

Substances

  • Dexmedetomidine
  • Sufentanil