Early tracheal extubation after paediatric cardiac surgery: the use of propofol to supplement low-dose opioid anaesthesia

Background: After institutional approval and parental consent, 103 children , aged 6 months to 18 years, who were undergoing repair of simple and compl ex congenital heart lesions using cardiopulmonary bypass (CPB) were studied and compared with a group of 135 children who had undergone similar surger y in our institution in the year before. Methods: Anaesthesia for study patients included fentanyl (< 20 <mu>g.kg(-1 )) and isoflurane. infusions of propofol (median infusion rate 70 mug.kg(-1 ).min(-1)) and morphine (median infusion rate 20 mug.kg-(1).h(-1)) were sta rted after weaning from CPB and continued postoperatively. Preestablished c riteria were used in the intensive care unit (ICU) to assess readiness for tracheal extubation. Results: Median time from admission to ICU to tracheal extubation was 5 h. Fifty-six children were extubated within 6 h and 73 within 9 h of ICU admis sion. Mean ICU stay for study patients was 1.7 days [95% confidence interva l (CI) 1.2-2.2] and 2.6 days (95% CI 2.3-2.9) in the comparison group (P<0. 005). Conclusions: We found the propofol regimen to be satisfactory with a shorte d ICU stay for these patients.