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Journal de Pharmacie Clinique

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Impact of propofol and sufentanil target controlled infusion with monitoring of bispectral index on drugs and medical devices costs in operating room and intensive care unit, for routine cardiac surgery with cardiopulmonary bypass Volume 23, issue 4, octobre-novembre-décembre 2004

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Authors
Service d’anesthésie-réanimation de l’hôpital G&R Laënnec, CHU de Nantes, Pharmacie de l’hôpital G&R Laënnec, CHU de Nantes

The aim of this prospective study was to assess the impact of a fast track strategy on drugs and medical devices costs in operating room and intensive care unit (ICU) for cardiac surgery with cardiopulmonary bypass. Fast track strategy included a target controled anesthesia, a monitoring of depth of anesthesia by bispectral index (BIS ®) and a very early wake-up and tracheal extubation after surgery. The study had two arms, the fast track (FT) arm and the standard procedure (SP) arm in witch patients received high doses of opioid for anaesthesia and were extubated several hours after surgery. We selected forty patients scheduled for coronary artery by-pass or aortic valve replacement; they were then randomly distributed in one of the two arms FT or SP. This work particularly assessed drugs and medical devices consumptions; it also studied postoperative mechanical ventilation duration in intensive care unit, blood transfusion and other clinical items. Results of the study showed smaller dosages of sufentanil administered to patients in the FT arm during surgery and a dramatic reduction of mechanical ventilation duration after surgery for these patients. Furthermore we could also note a reduction of drugs consumption in ICU for patients in the FT arm. The fast track strategy has been carried out without any significant increase of expense.