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https://hdl.handle.net/2440/46874
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DC Field | Value | Language |
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dc.contributor.author | Silbert, B. | - |
dc.contributor.author | Scott, D. | - |
dc.contributor.author | Evered, L. | - |
dc.contributor.author | Lewis, M. | - |
dc.contributor.author | Kalpokas, M. | - |
dc.contributor.author | Maruff, P. | - |
dc.contributor.author | Myles, P. | - |
dc.contributor.author | Jamrozik, K. | - |
dc.date.issued | 2006 | - |
dc.identifier.citation | Anesthesiology, 2006; 104(6):1137-1145 | - |
dc.identifier.issn | 0003-3022 | - |
dc.identifier.uri | http://hdl.handle.net/2440/46874 | - |
dc.description.abstract | BACKGROUND: Postoperative cognitive dysfunction (POCD) after coronary artery bypass graft surgery is a common complication for which, despite many clinical investigations, no definitive etiology has been found. The current use of both high- and low-dose fentanyl as anesthetic techniques allowed us to investigate the effect of fentanyl on the incidence of POCD. METHODS: Three hundred fifty patients scheduled to undergo elective coronary artery bypass graft surgery were randomized to receive either high-dose fentanyl (50 microg/kg) or low-dose fentanyl (10 mug/kg) as the basis of the anesthetic. All patients underwent neuropsychological testing before surgery and at 1 week, 3 months, and 12 months after surgery. RESULTS: One hundred sixty-eight patients in the low-dose group and 158 patients in the high-dose group were included in the final analysis. Neuropsychological testing was performed on 88%, 93%, and 92% of patients at 1 week, 3 months, and 12 months, respectively. There was no difference between group mean scores at any of the three testing times. Analysis of individual patients by the 20% rule did not detect any differences between groups. The one SD rule, which has fewer false-positive results, detected significantly more patients with POCD in the low-dose group than in the high-dose group at 1 week (23.6% vs. 13.7%; P = 0.03) but not at the other testing times. Patients with POCD spent an average of 1.2 days longer in the hospital than those without POCD (P = 0.021). CONCLUSIONS: High-dose fentanyl is not associated with a difference in the incidence of POCD at 3 or 12 months after surgery. Low-dose fentanyl leads to shorter postoperative ventilation times and may be associated with a greater incidence of POCD 1 week after surgery. Early POCD is associated with an increased duration of stay in the hospital. | - |
dc.language.iso | en | - |
dc.publisher | Lippincott Williams & Wilkins | - |
dc.source.uri | http://dx.doi.org/10.1097/00000542-200606000-00007 | - |
dc.title | A comparison of the effect of high- and low-dose fentanyl on the incidence of postoperative cognitive dysfunction after coronary artery bypass surgery in the elderly | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1097/00000542-200606000-00007 | - |
pubs.publication-status | Published | - |
Appears in Collections: | Aurora harvest General Practice publications |
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