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J Cardiothorac Vasc Anesth. 2010 Oct;24(5):785-9. doi: 10.1053/j.jvca.2010.03.018. Epub 2010 May 26.

The incidence of intraoperative awareness in cardiac surgery fast-track treatment.

Author information

1
Department of Anesthesiology and Intensive Care II, Leipzig Heart Center, University of Leipzig, Leipzig, Germany. medicine@groesdonk.net

Abstract

OBJECTIVE:

To determine the occurrence of intraoperative awareness with recall in cardiac surgery patients undergoing fast-track anesthetic management in a direct-admission postanesthetic care unit.

DESIGN:

Prospective.

SETTING:

University-affiliated heart center.

PARTICIPANTS:

Five hundred thirty-four patients undergoing fast-track anesthesia.

INTERVENTIONS:

Using a structured interview process as part of the quality-assurance program.

METHODS AND MAIN RESULTS:

All fast-track patients during an 8-month period were entered into the study at a university hospital. Each patient was interviewed by research staff with the same standard set of questions within the first 24 hours of surgery. Follow-up interviews were performed on day 3 or 4 as well as on day 6 or 7 postsurgery. Awareness was defined by the presence of explicit memory of any event from the induction of anesthesia to the recovery of consciousness in the postanesthetic care unit (PACU). A final study population of 514 patients was evaluated. None of the answers given by any patient during any of the 3 interviews indicated intraoperative awareness, with the exception of one 54-year-old male patient. Most likely, this potential awareness did not take place during the operation but was caused by inadequate awakening in the PACU.

CONCLUSION:

Therefore, the authors conclude that, with respect to intraoperative awareness, the "Leipzig Fast-Track Concept" with the use of ultra-short-acting opioids should be considered as a safe method of management of patients undergoing a wide variety of cardiac operations.

PMID:
20537922
DOI:
10.1053/j.jvca.2010.03.018
[Indexed for MEDLINE]

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