Sedatives during circulatory arrest are not necessary for aortic arch repair in acute type A aortic dissection

摘要

The standard protocol to maximize cerebral protection during open aortic arch surgery in acute type A aortic dissection (ATAAD) generally involves a combination of two perioperative strategies including hypothermic circulatory arrest (HCA) and cerebral perfusion in conjunction with pharmacologic agents (eg, barbiturates) as adjuncts for additional cerebral protection.[1–3] Pharmacologic agents are routinely used as an adjunct intraoperatively in a majority of cases despite minimal evidence supporting their use for incremental neurological protection.[1,3,4] Our study aims to evaluate the cerebral protection that intraoperative administration of adjunctive sedatives provides in aortic arch surgery with HCA and antegrade cerebral perfusion (ACP) in ATAAD. We hypothesize that adjunctive sedatives would not provide additional cerebral protection in aortic arch surgery with HCA and ACP, but would prolong patients’ wake-up and intubation time due to its sedative effect.