Spinal Anesthesia Associated With General Anesthesia in Coronary Artery Bypass

Study Overview
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Brief Summary
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CONTEXT: In patients eligible for coronary artery bypass surgery, anesthesia should provide a number of conditions that exceed the limits of cardiovascular stability, myocardial protection and other organs. Moreover, the combination of general anesthesia and spinal anesthesia lessens the homeostatic, metabolic, hormonal and immunosuppressive changes. The goal of this research was to evaluate the consumption of fentanyl citrate in intra-operative in Coronary Artery Bypass Grafting (CABG) surgery with cardiopulmonary bypass under spinal anesthesia associated with general anesthesia. METHODS: Clinical, prospective, randomized and double covered study, approved by the Research Ethics Committee. Fifty-six patients candidates for CABG with CPB, after signing the Terms of consent, were randomized and divided into two groups: GI - General and GII - General + subarachnoid. General anesthesia was induced according to the weight of each patient and maintenance with isoflurane and fentanyl. Spinal anesthesia was induced with 20 mg of 0.5% hyperbaric bupivacaine and 200 mcg of morphine, the patient is placed in cephalo-position slope of 45 degrees for 10 minutes in Group II. In the statistical study was performed using the Mann-Whitney test; the level of statistical significance was set at 5%.

Conditions
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Spinal Anesthesia, Myocardial Revascularization, Postoperative Care, Fentanyl

Intervention / Treatment
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* Procedure: General anesthesia only
* Procedure: General anesthesia and Spinal anesthesia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients of both genders Underwent cardiac artery bypass surgery with cardiopulmonary bypass, with No restriction on age No restriction on ethnicity No restriction on education or social class Exclusion Criteria: Patients with sternotomy provided; those Urgent surgery and/or emergency Patient was with signs of shock Patients with chronic renal failure Patients with liver disorders Tracheostomy patients Patients with presence of use of mechanical ventilatory support; Patients with physical disabilities; bedridden and wheelchair users. Patients to withdraw the Consent and Informed Patients who eventually had to be re-operated in the presence also of the mechanical ventilatory support.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: General anesthesia only<br>Anesthetic induction with etomidate 0,3 a 0,4 mg.kg-1, citrate fentanyl 5 mcg.kg-1 and atracurium 0,5.kg-1 | Procedure: General anesthesia only<br>* Induction drugs: Citrate of fentanyl, atracurium, etomidate<br>|
| Active Comparator: General anesthesia associated spinal anesthesia<br>spinal anesthesia using bupivacaine 0,5% hyperbaric 20 mg, morphine 200 mcg, set trendeleburg for 10 minutes, sensitive test in T1. Anesthetic induction with etomidate 0,3 a 0,4 mg.kg-1, citrate fentanyl 5 mcg.kg-1 and atracurium 0,5.kg-1. | Procedure: General anesthesia and Spinal anesthesia<br>* Induction drugs: Citrate of fentanyl, atracurium, etomidate Spinal anesthesia: Bupivacaine hyperbaric, Morphine<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| consumption of fentanyl citrate in intra-operative in Coronary Artery Bypass Grafting surgery with cardiopulmonary bypass under spinal anesthesia associated with general anesthesia. | Will be measure the consumption of fentanyl in 24 hours | in 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Vasoconstrictor Agents, Vasodilator Agents