• Francis C Parker, David A Story, Stephanie Poustie, Guoming Liu, and Larry McNicol.
• Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
• J. Cardiothorac. Vasc. Anesth. 2004 Oct 1; 18 (5): 613-9.

ObjectivesTo determine if anesthesia with sevoflurane or target-controlled propofol reduced the time to tracheal extubation after coronary artery bypass graft surgery compared with isoflurane anesthesia.DesignA 3-arm (isoflurane, sevoflurane, or propofol), randomized, controlled trial with patients and intensive care staff blinded to the drug allocation.SettingA single, tertiary referral hospital affiliated with the University of Melbourne.ParticipantsThree hundred sixty elective coronary artery surgery patients.InterventionsPatients received either isoflurane (control group, 0.5%-2% end-tidal concentration), sevoflurane (1%-4% end-tidal concentration), or target-controlled infusion of propofol (1-8 microg/mL plasma target concentration) as part of a balanced, standardized anesthetic technique including 15 microg/kg of fentanyl.Measurements And Main ResultsThe primary outcome was time to tracheal extubation. The median time to tracheal extubation for the propofol group was 10.25 hours (interquartile range [IQR] 8.08-12.75), the sevoflurane group 9.17 hours (IQR 6.25-11.25), and the isoflurane group 7.67 hours (IQR 6.25-9.42). Intraoperatively, the propofol group required less vasopressor (p = 0.002) and more vasodilator therapy (nitroglycerin p = 0.01, nitroprusside p = 0.002). There was no difference among the groups in time to intensive care unit discharge.ConclusionsThe median time to tracheal extubation was significantly longer for the target-controlled propofol group. A significantly greater number in this group required the use of a vasodilator to control intraoperative hypertension.

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