Background : The majority of propofol utilization as an induction anesthetic in cardiac surgery, particularly in cardiopulmonary bypass surgery led to several risks to the patient. The most common risk is dropped mean arterial pressure, even with the high risk of cardiac arrest. Objective : Determining the influences of ejection fraction value on the amount of propofol requirement as an induction agent based on the primary outcome (BIS spectral index) and the secondary outcomes (mean arterial pressure and heart rate). Design : Prospective study, analytical observational, multicenter, and multivariate analysis. Setting : 2 hospitals, including 1 teaching hospital and 1 private hospital Patients : all patients who underwent cardiopulmonary bypass surgery and are eligible for the inclusion criteria Measurements : Doses of Propofol as an anesthesia induction, mean arterial pressure (MAP) prior to surgery, heart rate (HR) prior to surgery, BIS Spectral Index prior to surgery, MAP after induction, HR after induction, and BIS Spectral Index after induction. Results : These data were analyzed using MATLAB R2022a software to obtain R2 (determining the effect size or influences) and p-value for each condition of ejection fraction value and the clinical responses. The data of this observational study is divided into six groups : 1. the effect size of ejection fraction value < 50% on BIS index obtained R2 0.9231 and p-value 0.88, 2. the effect size of ejection fraction value ≥ 50% on BIS index obtained R2 0.7794 and p-value 0.01, 3. the effect size of ejection fraction value < 50% on mean arterial pressure obtained R2 0.00024 and p-value 0.97, 4. The effect size of ejection fraction value ≥ 50% on mean arterial pressure obtained R2 0.0786 and p-value 0.005, 5. The effect size of ejection fraction value < 50% on heart rate obtained R2 0.3992 and p-value 0.06, 6. The effect size of ejection fraction value ≥ 50% on heart rate obtained R2 0.1757 and p-value 7.0776e-04. Conclusions : Propofol impacts BIS index value extremely compared to the mean arterial pressure or heart rate at the induction doses of propofol in general anesthesia for patients with a reduced ejection fraction.

中文翻译：

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体外射血分数值对异丙酚麻醉诱导需要量及其药效学特性影响的多元分析（基于临床结果的观察性研究）

背景：大多数异丙酚用作心脏手术中的诱导麻醉剂，特别是在体外循环手术中，这给患者带来了多种风险。最常见的风险是平均动脉压下降，即使心脏骤停的风险很高。目的：根据主要结果（BIS 光谱指数）和次要结果（平均动脉压和心率）确定射血分数值对作为诱导剂的异丙酚需求量的影响。设计：前瞻性研究、分析观察、多中心和多变量分析。地点：2 家医院，包括 1 家教学医院和 1 家私立医院患者：所有接受体外循环手术且符合纳入标准的患者测量：异丙酚作为麻醉诱导剂的剂量、手术前的平均动脉压 (MAP)、手术前的心率 (HR)、手术前的 BIS 光谱指数、诱导后的 MAP、诱导后的 HR 和诱导后的 BIS 光谱指数。结果：使用 MATLAB R2022a 软件分析这些数据以获得射血分数值和临床反应的每个条件的 R2（确定效应大小或影响）和 p 值。本观察研究的数据分为六组：1. 射血分数 < 50% 对 BIS 指数的影响大小获得 R2 0.9231 和 p 值 0.88， 2. 射血分数 ≥ 50% 对 BIS 的影响大小指数获得 R2 0.7794 和 p 值 0.01，3。射血分数值 < 50% 对平均动脉压的影响大小获得 R2 0.00024 和 p 值 0.97，4。射血分数值 ≥ 50% 对平均动脉压的影响大小获得 R2 0.0786 和 p 值 0.005, 5。射血分数值 < 50% 对心率的影响大小获得 R2 0.3992 和 p 值 0.06, 6。射血分数值 ≥ 50% 对心率的影响大小获得 R2 0.1757 和 p 值 7.0776e-04。结论：对于射血分数降低的患者，异丙酚在全麻诱导剂量下与平均动脉压或心率相比，异丙酚对 BIS 指数值的影响极大。