Computer-assisted continuous infusions of fentanyl during cardiac anesthesia: comparison with a manual method

• HIT Description: Decision support and computerized medication dosing. More info...
  
• Purpose of Study: Evaluate two computer-assisted methods of fentanyl infusion.
  
• Years of study: Not Available
  
• Study Design: Cntrl. Before/After
  
• Outcomes: Impact on patient safety, Impact on health care effectivness/quality, Other outcome
  

• Settings: Thirty patients schedule for CABG participated in the study.
• Intervention: A computer-assisted continuous infusion (CACI) system to rapidly attain and maintain a constant plasma fentanyl concentration (PFC), and a CACI system that allowed the anesthesiologist to change the plasma level of fentanyl during cardiac anesthesia were compared with a manual fentanyl administration method.
• Evaluation Method: Measures of agreement of dosing between systems, fentanyl levels, and adverse events.
• Description: The software of the CACI systems were written in ÒPASCALÓ, and the hardware used was an ÒApple Plus IIÓ computer, and an ÒIMED 929Ó infusion pump.
• Quality of Care and Patient Safety Outcome: There was excellent agreement in the measured/predicted PFC ratios with the CACI stable fentanyl level system (ratio = 0.99, n = 91) and in the CACI variable fentanyl level system (ratio = 1.08, n = 79). The stable fentanyl level group of patients received significantly more (P less than 0.05) fentanyl than did the other groups. The CACI variable fentanyl level group of patients had greater hemodynamic stability, required significantly (P less than 0.05) fewer adjuvant drug interventions and experienced significantly (P less than 0.05) fewer hypotensive and hypertensive episodes than the manual, bolus fentanyl (control) group.