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To evaluate the effect on cognitive function, recovery, cardioprotection and haemodynamics of standard Remifentanil anaesthesia to standard Sufentanil anaesthesia in patients undergoing coronary artery bypass with or without aortic valve replacement.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Remifentanil | Active Comparator | Remifentanil the basic opioid drug in anesthesia |
|
| Sufentanil | Active Comparator | Sufentanil the basic opioid drug in anesthesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Remifentanil | Drug | Randomization to receive Remifentanil (ultrashort acting opioid) as basic opioid in anaesthesia |
|
| Measure | Description | Time Frame |
|---|---|---|
| Cognitive function score | Cognitive function evaluated by Palo Alto Veterans Hospital Test on all patients | Postoperative day 4 |
| Fast-track potential | Ventilation time and eligible time to discharge based on ICU score | Time ((mean hours) to eligible discharge from ICU (up to 48 hours) |
| Measure | Description | Time Frame |
|---|---|---|
| Eligible time to discharge from ICU | Estimation on hours in ICU before the patients were eligible for discharge from ICU = ICD4 (Total score < 5, and no single score > 2) using an objective ICU score. The ICU score is done each hour after extubation | Time (hours) to ICD4 |
| Postoperative cognitive dysfunction |
| Measure | Description | Time Frame |
|---|---|---|
| Haemodynamic effects of opioids | Evaluation of haemodynamic indexes (cardiac index, stroke volume index, central venous oxygenation, blood pressure, Heart rate) together with echocardiographic evaluation of systolic and diastolic function. Evaluation both by single opioid and combination with propofol | From induction anaesthesia until cardiopulmonary bypass |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Carl-Johan Jakobsen, MD | Department of Anaesthesiology and Intensive Care, Aarhus University Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Aarhus University Hospital | Aarhus N | 8200 | Denmark |
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| D001024 | Aortic Valve Stenosis |
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D000077208 | Remifentanil |
| D017409 | Sufentanil |
| ID | Term |
|---|---|
| D011422 | Propionates |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
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| Sufentanil | Drug | Randomization to receive Sufentanil (medium/long acting opioid) as basic opioid in anaesthesia |
|
|
Changes from pre-operative cognitive function to postoperative cognitive function on day 1, 4 and 30 using cognitive function test from Palo Alto Veterans Hospital Test on all patients |
| Postoperative day 1 and 30 |
| Cardioprotection | Evaluation based on myocardial biochemical markers CK-MB, Troponin-T and Nt-Pro-BNP preoperative and 4, 9 and 15 and 40 hours after surgery | 0,4,9,15 and 40 hours after surgery |
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D000082862 | Aortic Valve Disease |
| D006349 | Heart Valve Diseases |
| D014694 | Ventricular Outflow Obstruction |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D010880 |
| Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D005283 | Fentanyl |