Sarcouncil Journal of Medicine and Surgery

Abstract: Background: There is a high rate of awareness during open heart surgery, which causes severe complications that endanger the patient’s life and potentially lead posttraumatic stress disorder. Various techniques have been employed to measure the depth of anesthesia and awareness by Entropy (EEG, EMG monitoring) autonomic response (H.R, B.P), Bispectral index (EEG monitoring) skin conductance (change in sweat production), lower esophageal contractility. Aims: In our study we try to compare the incidence of awareness by measuring the difference in level of entropy) EEG) in these two groups of anesthetic drugs ,1st group Remifentanil, 2nd group propofol. Patients and methods: A randomized prospective comparative clinical trial, of 44 adult patients were undergone open heart surgery,22 of them received Remifentanil, the other 22 patients received propofol both as maintenance of anesthesia. Before induction of anesthesia, we apply three forehead entropy leads to measure the depth of anesthesia in the pre cardiopulmonary bypass period. Results: There was significant decrease in awareness (state entropy) in R group, P value 0. 016m.The H. R significantly decrease in P Group P value 0. 046.While there is no significant difference in blood pressure in both groups. Conclusion: The use of Remifentanil for maintenance of anesthesia in open heart surgery is more suitable than propofol maintenance because it has shown less awareness and more hemodynamic stability.