Automated Postoperative Sedation After Cardiac Surgery

Postoperative Sedation After Cardiac Surgery : Comparison Between Manual Administration and Automated Sedation

This study compares automated administration of propofol and remifentanil guided by the Bispectral index (BIS) versus manual administration for sedation after cardiac surgery.

Automated sedation has the potential to improve patient care after cardiac surgery by adjusting drug doses to the minimum required for efficacy. Indeed, automated and continuous titration may avoid overdosing, improve hemodynamic stability and also decrease the mean time to tracheal extubation.

Medsteer SAS developed a controller, EasyTiva device, allowing the closed-loop coadministration of propofol and remifentanil, guided by a Bispectral Index (BIS) monitor.

Automated sedation is so facilitated by the BIS which permits continuous monitoring of electrocortical activity.

This randomized monocentric trial compares the automated administration with manual intravenous administration of propofol-remifentanil for maintaining adequate depth of hypnosis (BIS 55-75) during sedation after cardiac surgery.

Inclusion Criteria:

• Cardiac surgical procedure requiring postoperative sedation
• Low operative risk : EuroSCORE 2 ≤ 5%
• Consent for participation
• Affiliation to the social security system

Exclusion Criteria:

• Pregnant or breastfeeding women
• Neurological or muscular disorder
• Pacemaker
• Hypersensitivity to propofol or remifentanil
• Communication difficulties or neuropsychiatric disorder