Comparison of the effect of target control injection (TCI) of anesthetic with conventional method on creatinine level of patients with renal impairment in open heart surgery

Comparison of the effect of target control injection (TCI) of anesthetic with conventional method on creatinine level of patients with renal impairment in open heart surgery

Clinical trial with control group, with parallel groups, double-blind, randomized, phase 3 on 66 patients. In order to randomize, the block randomization method will be used.

In this study, all patients needed open heart surgery with renal impairment who referred to Rajai Hospital will be enrolled. Patients will be randomly divided into 3 groups based on 6 blocks. The sample size for each study group is 22. A total of 66 patients will be examined. Patients, surgeon and data analyzer will be blind.

Inclusion criteria: Patients who are candidates for open heart surgery who have creatinine greater than 1.5 mg / dl; patients over 18 years. Exclusion criteria: Patients over 70 years; pregnancy.

First intervention group: For anesthesia of patients with targeted controlled injection, Remy Fentanyl with a dose of 0.5 - 1 μ/kg, proponol with a dose of 2 - 2.5 mg/kg and then Atra with a dose of 0/15 - 0/2 mg/kg will be used. Second intervention group: for anesthesia of patients from Midazolam with a dose of 0.2 - 0.4 mg/kg, Fentanyl with a dose of 2-20 μg/kg and Atra with a dose of 0.005 - 0.01 mg/kg/min Will be infused continuously. Control group: For patients undergoing conventional anesthesia, Remi Fentanyl at a dose of 0.5-1 μ/kg, Proponol at a dose of 2 -2/5 mg/kg, and then Atra at a dose of 0.15 - 0.2 mg/kg will be used.

Total dose of anesthesia; Creatinine levels; Duration of hospitalization in the ICU

Patients will be randomly assigned to tree groups. In order to randomize, a random block method will be used. For this purpose, we formed blocks of size 6. In each block, 2 individuals will be in intervention group 1, 2 individuals will be in intervention group 2 and 2 will be in control group. A total of 11 blocks will be considered for the study.

Surgeons and patients will be kept blind and unaware of the type of anesthesia. Patients will be aware that they will be randomly assigned to one of three treatment groups, but will be unaware of which treatment will be provided in that group. Patients will be assigned to one of three groups using random number tables. The surgeon also knows that patients will be anesthetized in three different ways, but will not know which procedure will be performed for each patient. The data collection officer, analyst, outcome assessor and data safety and Data Safety and Monitoring Committee will collect and analyze information based on groups 1, 2 and 3 and will not be aware of the type of treatment provided in the groups. They will be kept blind.