Fast-track and ultra fast-track cardiac anaesthesia – postoperative pain and other parameters observation

Overview

Objective:
We have been using fast-track techniques (alfentanil and remifentanil based) for cardiac anaesthesia in our department routinely since 2001. The aim of this study was to compare these two methods.

Design:
A prospective follow-up study.

Setting:
Department of Cardiac Surgery, University Hospital Kralovske Vinohrady, Charles University, Prague.

Materials and methods:
In the prospective follow-up study, 71 consecutive patients (alfentanil 32, remifentanil 39) undergoing common cardiothoracic procedures were observed during 2006. The following parameters were observed: time to extubation, length of ICU stay, length of stay on ward, incidence of postoperative atrial fibrillation, blood gases, postoperative pain grade (assessed 1 hour after extubation and on 1st post - operative day on the visual analogue pain scale and the SF McGill questionnaire), analgesic requirements.

Results:
There were no statistically significant differences in the most of observed parameters. Postoperative pain was dependent solely on patient’s age (p < 0.001) and gender (p = 0.042).

Conclusion:
Both methods allow early and safe extubation of patients undergoing cardiothoracic surgery.

Key words:
cardiac anaesthesia – fast-track – alfentanil – remifentanil – pain