None listed
Conditions
Brief summary
The purpose of this study is to identify whether fast track cardiac anaesthesia is superior to usual care anaesthesia for patients undergoing primary coronary artery bypass grafting surgery. Who is it for? The study will include adult patients undergoing coronary artery bypass grafting surgery. This is a retrospective analysis of patients who underwent primary coronary artery bypass grafting (CABG) surgery via midline sternotomy who were managed by a fast-track protocol (fast-track group) or via usual care (usual care group). Fast track cardiac anaesthesia is a program using methadone with non-opioid adjuvant infusions (magnesium, ketamine, lidocaine, and dexmedetomidine) in patients undergoing CABG. Study details This study will evaluate the total mechanical ventilation time in hours adjusted for the hospital, body mass index, category of surgical urgency, cardiopulmonary bypass (CPB), and European System for Cardiac Operative Risk Evaluation (EuroSCORE II). We will evaluated other outcomes such as time taken to tracheal extubation, pain within the first 24 and 48 hours postoperatively, and postoperative opioid requirements within the first 24 and 48 postoperative hours. We will evaluate postoperative complications. It is hoped that this study will be hypothesis generating and provide valuable data for power calculations for future studies on evaluating the use of fast track surgery in patients undergoing primary coronary artery bypass grafting surgery.
Interventions
This is a retrospective analysis of patients who underwent primary coronary artery bypass
grafting (CABG) surgery via midline sternotomy who were managed by a fast-track protocol (fast-track group) or via usual care (usual care group). All data will be collected from patient electronic medical records, with no additional involvement by the participant required
Patients who undergo primary CABG surgery via midline sternotomy between February 2019 and February 2022 in Victoria will be screened.
This is a retrospective analysis of patients who underwent primary coronary artery bypass grafting (CABG) surgery via midline sternotomy who were managed by a fast-track protocol (fast-track group) or via usual care (usual care group). All data will be collected from patient electronic medical records, with no additional involvement by the participant required Patients who undergo primary CABG surgery via midline sternotomy between February 2019 and February 2022 in Victoria will be screened. Fast track cardiac anaesthesia is a program using methadone with non-opioid adjuvant infusions (magnesium, ketamine, lidocaine, and dexmedetomidine) in patients undergoing CABG. The following data will be collected for each patient:- 1. Baseline patient characteristics 2. Duration of anaesthesia and cardiopulmonary bypass 3. Total mechanical ventilation time in hours 4. Number of patients who have been successfully extubated within four postoperative hours 5. Pain scores within the first 48 hours postoperatively 6. Total intravenous (IV) opioid requirements within the first 24 and 48 postoperative hours 7. Time to mobilization in the ICU in hours. 8. Postoperative complications 9. Fluid use 10. Blood product use 11. Intensive care unit (ICU) and hospital length of stay (LOS) 12. Readmissions within 30 postoperative days 13. In-hospital and 30-day mortality
Sponsors
Austin Health - Austin Hospital - Heidelberg
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients who undergo primary CABG surgery via midline sternotomy will be screened between February 2019 and February 2022.
Exclusion criteria
The following patients will be excluded: 1. Time-critical salvage CABG (e.g., patients admitted with out-of-hospital arrest in cardiogenic shock requiring emergency CABG) 2. Patients undergoing CABG combined with valve surgery 3. Patients undergoing CABG combined with surgery on the aorta, 4. Patients undergoing redo surgeries 5. Patients with a preoperative cardiac assist device in situ 6. Patients undergoing CABG after 6 p.m. as these patients often remained on mechanical ventilation support until the next postoperative morning
Outcome results
None listed