Intensive Care Medicine

, 34:1683

Short-term sevoflurane sedation using the Anaesthetic Conserving Device after cardiothoracic surgery

  • Kerstin D. Röhm
  • Michael W. Wolf
  • Thilo Schöllhorn
  • Alexander Schellhaass
  • Joachim Boldt
  • Swen N. Piper
Original

DOI: 10.1007/s00134-008-1157-x

Cite this article as:
Röhm, K.D., Wolf, M.W., Schöllhorn, T. et al. Intensive Care Med (2008) 34: 1683. doi:10.1007/s00134-008-1157-x

Abstract

Objective

We evaluated the procedure of postoperative inhalational sedation with sevoflurane using the Anaesthetic Conserving Device (ACD) with regard to recovery times, feasibility and consumption of anaesthetics in comparison to propofol.

Design and setting

Prospective, randomised, single-blinded, controlled study in a surgical intensive care unit (ICU) of a 1,000-bed academic hospital.

Patients and interventions

A total of 70 patients after elective coronary artery bypass graft surgery either received sevoflurane via ACD (n = 35) or propofol (n = 35) for short-term postoperative sedation in the ICU.

Measurements and main results

The primary endpoint was extubation time from termination of sedation. Recovery times, consumption of anaesthetics, endtidal sevoflurane concentrations, length of ICU and hospital stay, and side effects were documented. Mean recovery times were significantly shorter with sevoflurane than with propofol (extubation time: 22 vs. 151 min; following commands: 7 vs. 42 min). The mean (SD) sevoflurane consumption was 3.2 ± 1.4 mL/h to obtain mean endtidal concentrations of 0.76 vol%. No serious complications occurred during sedation with either sedative drug. The length of ICU stay was comparable in both groups, but hospital length of stay was significantly shorter in the sevoflurane group. Drug costs (in Euro) for sedation per patient were similar in both groups (sevoflurane: 15.1 ± 9.5 €; propofol: 12.5 ± 5.8 €), while sevoflurane sedation costs that included use of the ACD were significantly higher.

Conclusions

Sevoflurane administration via ACD is an effective and safe alternative to propofol to provide postoperative short-term ICU sedation. Recovery from sedation was facilitated with sevoflurane instead of propofol and resulted in shorter extubation and ventilator times.

Descriptor

Neurology/sedation, Sedation and anaesthesia.

Keywords

Volatile anaestheticsSevofluranePropofolSedationAnaesthetic Conserving DeviceIntensive care unit

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Kerstin D. Röhm
    • 1
  • Michael W. Wolf
    • 1
  • Thilo Schöllhorn
    • 1
  • Alexander Schellhaass
    • 1
  • Joachim Boldt
    • 1
  • Swen N. Piper
    • 1
  1. 1.Department of Anaesthesiology and Intensive Care MedicineKlinikum LudwigshafenLudwigshafenGermany