Photo Credit: Andrey Shevchuk
The following is a summary of “Volatile versus propofol sedation after cardiac valve surgery: a single-center prospective randomized controlled trial,” published in the April 2024 issue of Critical Care by Flinspach et al.
Despite the need for close monitoring after valve surgery, the optimal sedation method (volatile vs. propofol) for balancing patient comfort with timely awakening in the ICU remains unclear.
Researchers conducted a retrospective study evaluating the time to extubation and the associated workload of healthcare providers with volatile versus propofol sedation following cardiac valve surgery.
They undertook a prospective randomized single-center trial at a tertiary university hospital to assess postoperative care for patients undergoing open valve surgery. The trial randomized the administration of volatile sedation versus propofol sedation. Sedation ceased 60 minutes post-admission for critical postoperative observation.
The results showed a notable difference in extubation time (91 ± 39 min vs. 167 ± 77 min; P<0.001), eye-opening (86 ± 28 min vs. 151 ± 71 min; P<0.001), and command compliance (93 ± 38 min vs. 164 ± 75 min; P<0.001) with volatile sedation, along with an increased median setup time of 9:56 min (± 4:16 min). No differences in complications were observed, and cardiopulmonary bypass time remained similar between groups at 101 (IQR 81; 113) vs. 112 (IQR 79; 136) minutes (P=0.36).
Investigators concluded that volatile sedation while requiring slightly more initial setup, resulted in a significantly faster time to extubation for this vulnerable patient population.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04899-y