scholarly journals Remimazolam anesthesia for cardiac surgery with cardiopulmonary bypass: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kota Saito ◽  
Sho Ohno ◽  
Makishi Maeda ◽  
Naoyuki Hirata ◽  
Michiaki Yamakage
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Oxygen Saturation ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Maze Procedure ◽  
Intraoperative Awareness ◽  
Case Presentation ◽  
Venous Oxygen Saturation ◽  
Index Value

Abstract Background Remimazolam has less cardiovascular depressant effects than propofol in non-cardiac surgical patients. However, the efficacy and safety of remimazolam in cardiac surgery with cardiopulmonary bypass (CPB) have not been reported. We present a case of successful anesthetic management using remimazolam in cardiac surgery with CPB. Case presentation A 76-year-old female was scheduled for mitral valve repair, tricuspid annuloplasty, maze procedure, and left atrial appendage closure. We used remimazolam in induction (6.0 mg/kg/h) and maintenance (0.6–1.0 mg/kg/h) of general anesthesia, and the bispectral index value was maintained in the range of 36 to 48 including the period of CPB. Hemodynamics, mixed venous oxygen saturation, and bilateral regional cerebral oxygen saturation were maintained within acceptable ranges. There was no intraoperative awareness/recall or serious complications associated with remimazolam throughout the perioperative period. Conclusions Remimazolam can be used the same as other existing anesthetics in cardiac surgery with CPB.

Continuous mixed venous and central venous oxygen saturation in cardiac surgery with cardiopulmonary bypass

2010 ◽  
Vol 27 (3) ◽  
pp. 295-299 ◽  
Author(s):  
Pierre-Yves Lequeux ◽  
Yves Bouckaert ◽  
Hicham Sekkat ◽  
Philippe Van der Linden ◽  
Constantin Stefanidis ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Oxygen Saturation ◽  
Central Venous Oxygen Saturation ◽  
Central Venous ◽  
Venous Oxygen Saturation ◽  
Mixed Venous

scholarly journals Relationship between Anesthetic Depth and Venous Oxygen Saturation during Cardiopulmonary Bypass

2010 ◽  
Vol 113 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Erica J. Stein ◽  
David B. Glick ◽  
Mohammed M. Minhaj ◽  
Melinda Drum ◽  
Avery Tung
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Oxygen Saturation ◽  
Anesthetic Depth ◽  
Venous Oxygen Saturation ◽  
Limited Variation ◽  
Data Points ◽  
Inhaled Anesthetic ◽  
The Relationship ◽  
Unadjusted Analysis

Background During cardiopulmonary bypass, mixed venous oxygen saturation (Svo2) is frequently measured to assess circulatory adequacy. Fluctuations in Svo2 not related to patient movement or inadequate oxygen delivery have been attributed clinically to increased cerebral oxygen consumption due to "light" anesthesia. To evaluate the relationship between anesthetic depth and Svo2, we prospectively measured bispectral index (BIS) and Svo2 values in patients undergoing cardiac surgery with cardiopulmonary bypass. Methods Adults scheduled for cardiac surgery with cardiopulmonary bypass were recruited for this prospective observational study. During bypass, BIS and Svo2 values were recorded every 5 min. To control for confounding effects of changes in other variables known to affect Svo2, temperature, hematocrit, bypass pump flow, muscle relaxant use, and intravenous and inhaled anesthetic doses were also recorded. Only periods with limited variation in other variables affecting Svo2 were analyzed. The relationship between BIS and Svo2 was evaluated using mixed linear regression. Results One thousand thirty-four data points were obtained in 41 patients. No overall association between BIS and Svo2 was observed, either in unadjusted analysis or adjusted for covariates. In data points with temperatures less than the median (T < 34.1 degrees C), a significant association between BIS and Svo2 was observed both in unadjusted (beta = -0.32, P = 0.01) and adjusted (beta = -0.27, P = 0.04) analyses. Conclusions In patients undergoing cardiopulmonary bypass, we found no overall association between BIS and Svo2. A weak but statistically significant association between BIS and Svo2 was observed in patients with temperatures less than 34.1 degrees C. These data suggest that low Svo2 values on bypass are unlikely to be due to light or inadequate anesthesia. The relationship among temperature, BIS and Svo2 deserves further study.

Volatile anaesthetics added to cardiopulmonary bypass are associated with reduced cardiac troponin

Perfusion ◽  
2017 ◽  
Vol 32 (7) ◽  
pp. 547-553 ◽  
Author(s):  
Elena Bignami ◽  
Marcello Guarnieri ◽  
Marina Pieri ◽  
Francesco De Simone ◽  
Alcira Rodriguez ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Myocardial Necrosis ◽  
Perioperative Period ◽  
Cardiac Surgical Procedures ◽  
Control Group ◽  
Volatile Anaesthetics ◽  
Volatile Agents

Background: Every year, over 1 million cardiac surgical procedures are performed all over the world. Reducing myocardial necrosis could have strong implications in postoperative clinical outcomes. Volatile anaesthetics have cardiac protective properties in the perioperative period of cardiac surgery. However, little data exists on the administration of volatile agents during cardiopulmonary bypass. The aim of this study was to assess if volatile anaesthetics administration during cardiopulmonary bypass reduces cardiac troponin release after cardiac surgery. Materials and methods: We retrospectively analysed data from 942 patients who underwent cardiac surgery in a teaching hospital. The only difference between the groups was the management of anaesthesia during CPB. The volatile group received sevoflurane or desflurane while the control group received a combination of propofol infusion and fentanyl boluses. Patients who received volatile anaesthetics during cardiopulmonary bypass (n=314) were propensity-matched 1:2 with patients who did not receive volatile anaesthetics during CPB (n=628). Results: We found a reduction in peak postoperative troponin I, from 7.8 ng/ml (4.8-13.1) in the non-volatile group to 6.8 ng/ml (3.7-11.8) in the volatile group (p=0.013), with no differences in mortality [2 (0.6%) in the volatile group and 2 (0.3%) in the non-volatile group (p=0.6)]. Conclusions: Adding volatile anaesthetics during cardiopulmonary bypass was associated with reduced peak postoperative troponin levels. Larger studies are required to confirm our data and to assess the effect of volatile agents on survival.

Cyclic Decrease in Mixed Venous Oxygen Saturation for the Early Diagnosis of Seizure Complications After Cardiac Surgery

1995 ◽  
Vol 80 (2) ◽  
pp. 404-407
Author(s):  
Naoki Yahagi ◽  
Keiji Kumon ◽  
Takuya Umemoto ◽  
Hitoshi Shimura ◽  
Akira T. Kawaguchi ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Early Diagnosis ◽  
Oxygen Saturation ◽  
Mixed Venous Oxygen Saturation ◽  
Venous Oxygen Saturation ◽  
Mixed Venous

scholarly journals Prognostic value of central venous oxygen saturation during anesthesia for cardiac surgery.

2020 ◽  
Vol 24 (2) ◽  
pp. 33-39
Author(s):  
marwa mahrous ◽  
Khaled Hassan ◽  
Abdelrahman Abdelrahman ◽  
Abd El Hady Helmy
Keyword(s):  
Cardiac Surgery ◽  
Oxygen Saturation ◽  
Prognostic Value ◽  
Central Venous Oxygen Saturation ◽  
Central Venous ◽  
Venous Oxygen Saturation
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