Opioid Reduced Anesthesia With Parasternal CATheters on Postoperative Delirium After Cardiac Surgery

Opioid Reduced Anesthesia With Parasternal CATheters on Postoperative Delirium After Cardiac Surgery

PostOperative Delirium (POD) is the most common neuropsychiatric complication following cardiac surgery and may be related to morphine consumption. PostOperative Delirium (POD) prolongs hospital and intensive care unit (ICU) length of stay (LOS) and increases morbidity and mortality. No study has been conducted to demonstrate the effect of regional anesthesia using catheters inserted before sternotomy.

This study investigate the effect of an enhanced recovery protocol using regional anesthesia on PostOperative Delirium (POD) onset.

Inclusion Criteria:

• Age over 18
• Admitte for scheduled cardiac surgery with sternotomy under cardiopulmonary bypass (CPB) for coronary artery bypass grafting (CABG), surgical correction of valve disease (aortic, mitral or tricuspid) or combined surgery (coronary artery bypass grafting (CABG) and valve replacement).

Exclusion Criteria:

• Age over 85,
• emergency surgery or heart transplant,
• body mass index (BMI) more than 40 kg.m-2
• reoperation
• Renal insufficiency with glomerular filtration rate (GFR) less than 30 mL.min-1
• left ventricular ejection fraction less than 30%
• respiratory insufficiency with arterial pressure of oxygen less than 60 mmHg
• hepatic insufficiency with prothrombin rate less than 30% or cirrhosis
• chronic hyperglycemia not controlled
• pregnancy
• cognitive impairment chronic use of opioids or drug addiction
• epilepsy
• guardianship
• allergy to locals anesthesics or any drugs