Wake-up times following sedation with sevoflurane versus propofol after cardiac surgery

Figures & data

Figure 1. Flowchart of the study. CABG, coronary artery bypass grafting; CPB, cardio pulmonary bypass; ICU-MT, Intensive Care Unit Memory Tool; n, number.

Table I. Pre- and perioperative patient group characteristics.

Data	Sevoflurane (n =49)	Propofol (n =50)	P-value
Age, years (SD)	65 (8)	66 (11)	0.495
BMI (SD), index kg/m^2 (SD)	28.8 (2)	27.3 (4.6)	0.729
Female, n	12	8	0.298
Euroscore, score number (SD)	3.8 (2.1)	4.3 (2.8)	0.276
Euroscore logistic mortality, % (SD)	3.31 (2.6)	4.53 (4.0)	0.078
CPB time, minutes (SD)	62 (25)	70 (19)	0.077
Duration of anesthesia, minutes (SD)	206 (39)	212 (48)	0.509
Total dose of fentanyl, mg (SD)	0.50 (0.14)	0.52 (0.11)	0.982
Total dose of midazolam, mg (SD)	1.5 (1.1)	1.6 (1.1)	0.615

BMI, body mass index; CPB, cardio-pulmonary bypass; n, number; SD, standard deviation.

Table II. Drug sedation and extubation.

Drugs and mean dose	Sevoflurane (n =49)	Propofol (n =50)	P-value
Mean propofol dose, mg/kg/h (SD)	–	2.0 (0.7)	–
Mean sevoflurane dose, ml/h (SD)	3.8 (0.9)	–	–
Mean endtidal sevoflurane, % (SD)	0.8 (0.18)	–	–
Median time study drug administration, minutes (IQR/total range)	165 (69/238)	185 (116/830)	0.268
Mean morphine infusion, mg/h first 6 hours (SD)	1.44 (0.47)	1.36 (0.45)	0.355
Median time drug stop to extubation, minutes (IQR/total range)	10 (10/100)	25 (21/240)	<0.001
Median ICU mechanical ventilation, minutes (IQR/total range)	185 (74/230)	215 (108/1056)	0.056

IQR, interquartile range; n, number; SD, standard deviation.

Figure 2. Time to extubation. •, outlying point more than 1.5 box widths.

Figure 3. Time to adequate verbal response.

Table III. Adverse recovery events first 12 hours following extubation.

Effect	Sevoflurane (n =49)	Propofol (n =50)	P-value
Postoperative nausea and vomiting, n	12	9	0.470
Severe pain after extubation of NRS ≥8, n	3	1	0.362
Shivering, n	2	1	0.617
Agitation requiring pharmacological treatment, n	1	0	0.495
Need of non-invasive ventilation, n	3	5	0.715

NRS, numeric rating scale 0–10; n, number.

Table IV. ICU and hospital stay.

Effect	Sevoflurane (n =49)	Propofol (n =50)	P-value
Median ICU stay, hours (IQR/total range)	22 (5/74)	22 (4/246)	0.364
Median hospital stay, days (IQR/total range)	6 (2/8)	6 (2/44)	0.866
ICU stay ≥24 hours, n	10	10	1.0
ICU stay ≥48 hours, n	5	5	1.0
Re-admission to ICU, n	1	5	0.204

n, number; IQR, interquartile range; SD, standard deviation.

Table V. ICU Memory Tool data.

Data	Sevoflurane (n =49)	Propofol (n =50)	P-value
Questionnaire responders in study groups, % (n)	86.0 (44)	92.0 (46)	0.74
Clear memories of the hospital admission, %* (n)	100 (44)	93.5 (43)	0.24
Clear memories from the ICU stay, %* (n)	38.6 (17)	50.0 (23)	0.30
Factual memories from the ICU stay, %* (n)	84.1 (37)	84.8 (39)	1.00
Endotracheal tube, %* (n)	4.5 (2)	10.9 (5)	0.44
Delusional memories from the ICU stay, %* (n)	20.5 (9)	28.3 (13)	0.47
Dreams, %* (n)	15.9 (7)	13.0 (6)	0.77
Nightmares, %* (n)	9.1 (4)	17.4 (8)	0.36
Hallucinations, %* (n)	6.8 (3)	13.0 (6)	0.49
Paranoia, %* (n)	4.5 (2)	4.3 (2)	1.00
Memories of feelings from the ICU stay %* (n)	54.5 (24)	60.9 (28)	0.67
Confusion, %* (n)	29.5 (13)	15.2 (7)	0.13
Anxiety, %* (n)	18.2 (8)	19.6 (9)	1.0
Panic, %* (n)	4.5 (2)	0 (0)	0.24
Feeling uncomfortable, %* (n)	18.2 (8)	21.7 (10)	0.79
Feeling down, %* (n)	6.8 (3)	17.4 (8)	0.20
Pain, %* (n)	20.9 (9)	28.3 (13)	0.47

%*, percent within group of completed ICU Memory Tool (excluding loss to follow-up); n, number; SD, standard deviation.