• Ricardo Antonio Guimarães Barbosa, Luiz Marcelo Sá Malbouisson, Luciana Moraes dos Santos, Marilde de Albuquerque Piccioni, and Maria José Carvalho Carmona.
• Medical School, Universidade de São Paulo.
• Rev Bras Anestesiol. 2012 May 1; 62 (3): 289-97.

Background And ObjectivesExtracorporeal circulation (ECC) may change drug pharmacokinetics as well as brain function. The objectives of this study are to compare emergence time and postoperative sedation intensity assessed by the bispectral index (BIS) and the Ramsay sedation scale in patients undergoing myocardial revascularization (MR) with or without ECC.MethodTen patients undergoing MR with ECC (ECC group) and 10 with no ECC (no-ECC group) were administered with sufentanyl, propofol 2.0 μg.mL(-1) and pancuronium target controlled infusion. After surgery, propofol infusion was reduced to 1 μg.mL(-1) and suspended when extubation was indicated. Patients BIS, Ramsay scale and time to wake up were assessed.ResultsThe ECC group showed lower BIS values beginning at 60 minutes after surgery (no-ECC = 66±13 and ECC = 53±14, p=0.01) until 120 minutes after infusion (no-ECC = 85±8 and ECC = 73±12, p=0.02). Sedation level measured by the Ramsay scale was higher in the ECC group at 30 minutes after the end of the surgery (no-ECC = 5±1 and ECC = 6±0, p=0.021), at the end of infusion (no-ECC = 5±1 and ECC = 6±1, p=0.012) and 5 minutes after the end of infusion (no-ECC = 4±1 and ECC = 5±0.42, p=0.039). Emergence from anesthesia time was higher in the ECC group (no-ECC = 217±81 and ECC = 319±118, p=0.038).ConclusionsThere was a higher intensity of sedation after the end of surgery and a longer wake up time in ECC group, suggesting changes in the pharmacokinetics of propofol or effects of ECC on central nervous system.Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

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