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Related Experiment Videos

Intraoperative awareness in fast-track cardiac anesthesia

N P Dowd1, D C Cheng, J M Karski

  • 1Department of Anesthesia, The Toronto Hospital, University of Toronto, Ontario, Canada.

Anesthesiology
|November 20, 1998
PubMed
Summary

Fast-track cardiac anesthesia is associated with a very low incidence of intraoperative awareness (0.3%). This technique, utilizing specific anesthetic agents, appears to minimize patient memory during cardiac surgery.

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Area of Science:

  • Anesthesiology
  • Cardiac Surgery
  • Patient Safety

Background:

  • Fast-track cardiac anesthesia employs low-dose narcotics and short-acting agents to enable early extubation post-cardiac surgery.
  • The incidence of intraoperative awareness with this specific anesthetic approach remained uninvestigated prior to this study.

Purpose of the Study:

  • To prospectively determine the incidence of intraoperative awareness with explicit memory during fast-track cardiac anesthesia.

Main Methods:

  • A prospective study involved 617 adult patients undergoing cardiac surgery with a fast-track anesthetic regimen.
  • Patients were interviewed 18 hours post-extubation to assess for explicit memory of intraoperative events.

Main Results:

  • Two out of 617 patients (0.3%) reported explicit memory of intraoperative events, with one experiencing pain.

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  • No adverse psychological sequelae were reported by the patients who experienced awareness.

    • Conclusions:

    • The study reports a 0.3% incidence of awareness in fast-track cardiac anesthesia, the lowest reported for cardiac surgery.
    • This low incidence may be attributed to balanced anesthetic techniques using continuous volatile or intravenous agents throughout cardiopulmonary bypass.