Cardiothoracic & vascular anesthesia
Implementing Ultra–Fast-Track Cardiac Anesthesia in Minimally Invasive Cardiac Surgery
Authors' conclusion
Seven independent factors were identified for UFTCA implementation in MICS, among which age >50 years, history of stroke, duration of CPB, intraoperative sufentanil dosage, and surgery ending after 8 pm were negative factors and pectoral muscle fascial plane block and dexamethasone use were positive factors. The use of UFTCA in MICS shortened ICU stay and hospital stay, decreased the incidence of delirium, and promoted postoperative pulmonary function.
Study context
- Population
- Patients with minimally invasive cardiac surgery (MICS), January 2021 through July 2023947 analysed
- Participants
- 967 patients
- Exposure
- Ultra-fast-track cardiac anesthesia vs conventional cardiac anesthesia
- Ultra-fast-track cardiac anesthesia (UFTCA)n = 439
- CGAn = 508reference
- Outcome
- Independent factors associated with UFTCA implementation
Methodological detailsmultivariate logistic regression
- Multivariate logistic regression
Main finding
As reported in the abstract
- Age >50 years · negative factor
- OR 1.924; P = 0.040
- History of stroke · negative factor
- OR 2.290; P = 0.009
- Duration of cardiopulmonary bypass (CPB) · negative factor
- OR 1.013; P < 0.001
- Intraoperative sufentanil dosage · negative factor
- OR 1.035; P < 0.001
- Surgery ending after 8 pm · negative factor
- OR 2.184; P < 0.001
- Pectoral muscle fascial plane block · positive factor
- OR 0.120; P < 0.001
- Dexamethasone · positive factor
- OR 0.438; P < 0.001
Observational data: associations, not effects.
Further findings
ICU rescue analgesia
P < 0.001
Postoperative delirium
P = 0.001
ICU LOS
P < 0.001
| Outcome | UFTCA | CGA | P value |
|---|---|---|---|
| Postoperative hospital LOS | mean 8 ± 3 days | mean 10 ± 5 d | P < 0.001 |
Oxygenation index · 1 and 6 hours postsurgery
- Lower at 1 hour but higher at 6 hours postsurgery with UFTCA vs CGA
- P < 0.05
Safety
PONV
P = 0.002
Original publication
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