Anaesthesia for cardiac surgery
Conditions
Interventions
dexmedetomidine group (group D):dexmedetomidine (0.5 µg/kg loading, 0.5 µg/kg/h infusion)
dexmedetomidine plus low-dose esketamine group (group DEl):dexmedetomidine (0.5 µg/kg loading, 0.3 µg/kg/h infusion) and esketamine (0.5 mg/kg loading, 5 µg/kg/min infusion)
dexmedetomidine plus high-dose esketamine group (group DEh ):dexmedetomidine (0.5 µg/kg loading, 0.3 µg/kg/h infusion) and esketamine (0.5 mg/kg loading, 10 µg/kg/min infusion)
Sponsors
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vascular Diseases
Eligibility
Sex/Gender
All
Age
70 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. patients with severe symptomatic aortic valve stenosis; 2. age >=75 years; 3. at high risk for conventional surgical aortic valve replacement were eligible for enrolment (ie, logistic European System for Cardiac Operative Risk Evaluation >=20% or Society of Thoracic Surgeons risk score >=10% or other high risk criteria by heart team consensus); 4. suitability for transfemoral vascular access were also required.
Exclusion criteria
Exclusion criteria: 1. contraindication for a specific mode of anesthesia or the TAVR procedure; 2. clear patient specific clinical reasons to prefer one form of anesthesia over the other; 3. cardiogenic shock or hemodynamic instability; 4. history of or active endocarditis; 5. active infection requiring antibiotic treatment; 6. active peptic ulcer or upper gastrointestinal bleeding< 3 months; 7. hypersensitivity or contraindication to aspirin, heparin, or clopidogrel; 8. neurocognitive/neurodegenerative disease or psychiatric disorder, or using antidepressants/sedatives were excluded.; 9. and participation in another trial. Secondary exclusion criteria were perioperative emergency conversion from sedation to general anesthesia and the need for cardiopulmonary resuscitation during the study period.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Recovery -15 (QoR-15) score;Perioperative self-rated anxiety scale (SAS) score;Postoperative Insomnia Scale (AIS) score;Hospital Anxiety and Depression Scale (HADS) score; | — |
Secondary
| Measure | Time frame |
|---|---|
| Intraoperative BIS;Heart rate;Systolic and diastolic blood pressure;Wake time;Vasoactive and inotropic needs and doses;Sedation start time;Oxygen saturation;Length of hospital stay and pre-medication related adverse reactions;Mean Intensive Care Unit (ICU);Mean length of hospital stay; | — |
Countries
China
Contacts
Public ContactZhang Liang
Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vascular Diseases
Outcome results
None listed