Intravenous Caffeine for Adult Patients with Obstructive Sleep Apnea Undergoing Uvulopalatopharyngoplasty: Effects on Postoperative Respiratory Complications and Recovery Profile
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- Category: Vol. 78, March 2010
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Intravenous Caffeine for Adult Patients with Obstructive Sleep Apnea Undergoing Uvulopalatopharyngoplasty: Effects on Postoperative Respiratory Complications and Recovery Profile,NEVINE M. GOUDA
Abstract
Background: This randomized double blind placebo con-trolled study, aimed at investigating the effects of intravenous caffeine benzoate on post extubation adverse respiratory events and recovery from sevoflurane anesthesia in patients with obstructive sleep apnea (OSA) undergoing uvulo-palatopharyngoplasty (UPPP).
Methods: 60 patients ASA I and II scheduled for UPPP for OSA were blindly grouped to receive either 500mg caffeine benzoate or 0.9% normal saline as placebo control following completion of surgery and discontinuation of sevoflurane. Premedication was omitted. Anesthesia was induced with propofol 2mg/kg, fentanyl 1mg/kg and atracurium 0.05mg/kg. Anesthesia was maintained with sevoflurane 2.5-3% in 100% oxygen, atracurium 0.1mg/kg was used for further muscle relaxation and no other narcotics were used intraoperatively. After injection of the study drug the following were recorded: BIS values and heart rate for 15 minutes, in addition time to eye opening, extubation, response to verbal commands and duration of recovery as well as duration of PACU stay and compared in both groups. The number of patients who devel-oped post extubation respiratory complications is recorded during the recovery period and in the PACU and compared in both groups.
Results: Recovery times (Time to eye opening, extubation, response to verbal commands and duration of recovery as well as duration of PACU stay) were significantly shorter in the caffeine group P<0.05. The BIS values were significantly higher in the caffeine group from minute 3 to minute 11 compared to the placebo. P<0.05.The mean heart rate increased in the caffeine group from minute 4 to 9 P<0.05, but this finding was clinically insignificant. The number of patients who developed adverse post extubation events during the recovery period and in the PACU was significantly less in the caffeine group compared to the placebo P<0.05.
Conclusion: The current study demonstrated that admin-istration of caffeine benzoate to patient with OSA scheduled for UPPP decreases the number of patients who developed adverse post extubation respiratory events and hastens recovery from sevoflurane anesthesia.