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A Comparative Study Evaluating Effects of Intravenous Sedation by Dexmedetomidine and Propofol on Patient Hemodynamics and Postoperative Outcomes in Cardiac Surgery

BACKGROUND: The use of intravenous sedation during cardiac surgery to reduce awareness has been practised routinely during past few years and the two most commonly used drugs include propofol and dexmedetomidine, but their effects on hemodynamics and postoperative outcomes in cardiac surgery is cont...

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Autores principales: Sheikh, Tufail Ahmad, Dar, Bashir Ahmad, Akhter, Nihida, Ahmad, Nadeem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020583/
https://www.ncbi.nlm.nih.gov/pubmed/29962634
http://dx.doi.org/10.4103/aer.AER_46_18
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author Sheikh, Tufail Ahmad
Dar, Bashir Ahmad
Akhter, Nihida
Ahmad, Nadeem
author_facet Sheikh, Tufail Ahmad
Dar, Bashir Ahmad
Akhter, Nihida
Ahmad, Nadeem
author_sort Sheikh, Tufail Ahmad
collection PubMed
description BACKGROUND: The use of intravenous sedation during cardiac surgery to reduce awareness has been practised routinely during past few years and the two most commonly used drugs include propofol and dexmedetomidine, but their effects on hemodynamics and postoperative outcomes in cardiac surgery is continually being evaluated. AIMS: The aim of this study was to compare the effects of anesthesia by dexmedetomidine and propofol on the hemodynamic variables and postoperative outcomes in patients who were planned for elective cardiac surgery. SETTINGS: Cardiac operating room of a tertiary care hospital. DESIGN: A prospective, randomized controlled, double-blind clinical trial. MATERIALS AND METHODS: Sixty patients were randomized to receive either a continuous infusion of propofol (0.25–1 mg/kg/h) or dexmedetomidine bolus of 1 μg/kg over 10 min followed by infusion (0.2–0.6 μg/kg/h) after induction of anesthesia. The anesthesia technique and physiological monitoring including bispectral index monitoring were similar among both the groups. Hemodynamic variables (mean heart rate [HR], mean arterial pressure [MAP]) were noted at predefined time intervals, intraoperative vasopressor or inotrope requirements and postoperative outcomes including postoperative ventilation time and length of stay in the Intensive Care Unit (ICU) were also recorded. STATISTICAL ANALYSIS: Statistics was done using SPSS V 20 (IBM, NY) using Student's t-test, analysis of variance, and Mann–Whitney U-test, and a P < 0.05 was considered to indicate a significant difference. RESULTS AND CONCLUSIONS: HR and MAP were significantly less in dexmedetomidine group compared to propofol group (P < 0.05). Both the groups had a similar requirement of vasopressors and inotropes. The duration of postoperative ventilation and length of stay in the ICU were significantly shorter in the dexmedetomidine group (P < 0.05). The risk of delirium was significantly less in dexmedetomidine group (P < 0.05). From our study we concluded, that the perioperative infusion of dexmedetomidine produces better hemodynamic stability, reduces the risk of postoperative delirium, and leads to shorter ICU stay.
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spelling pubmed-60205832018-06-29 A Comparative Study Evaluating Effects of Intravenous Sedation by Dexmedetomidine and Propofol on Patient Hemodynamics and Postoperative Outcomes in Cardiac Surgery Sheikh, Tufail Ahmad Dar, Bashir Ahmad Akhter, Nihida Ahmad, Nadeem Anesth Essays Res Original Article BACKGROUND: The use of intravenous sedation during cardiac surgery to reduce awareness has been practised routinely during past few years and the two most commonly used drugs include propofol and dexmedetomidine, but their effects on hemodynamics and postoperative outcomes in cardiac surgery is continually being evaluated. AIMS: The aim of this study was to compare the effects of anesthesia by dexmedetomidine and propofol on the hemodynamic variables and postoperative outcomes in patients who were planned for elective cardiac surgery. SETTINGS: Cardiac operating room of a tertiary care hospital. DESIGN: A prospective, randomized controlled, double-blind clinical trial. MATERIALS AND METHODS: Sixty patients were randomized to receive either a continuous infusion of propofol (0.25–1 mg/kg/h) or dexmedetomidine bolus of 1 μg/kg over 10 min followed by infusion (0.2–0.6 μg/kg/h) after induction of anesthesia. The anesthesia technique and physiological monitoring including bispectral index monitoring were similar among both the groups. Hemodynamic variables (mean heart rate [HR], mean arterial pressure [MAP]) were noted at predefined time intervals, intraoperative vasopressor or inotrope requirements and postoperative outcomes including postoperative ventilation time and length of stay in the Intensive Care Unit (ICU) were also recorded. STATISTICAL ANALYSIS: Statistics was done using SPSS V 20 (IBM, NY) using Student's t-test, analysis of variance, and Mann–Whitney U-test, and a P < 0.05 was considered to indicate a significant difference. RESULTS AND CONCLUSIONS: HR and MAP were significantly less in dexmedetomidine group compared to propofol group (P < 0.05). Both the groups had a similar requirement of vasopressors and inotropes. The duration of postoperative ventilation and length of stay in the ICU were significantly shorter in the dexmedetomidine group (P < 0.05). The risk of delirium was significantly less in dexmedetomidine group (P < 0.05). From our study we concluded, that the perioperative infusion of dexmedetomidine produces better hemodynamic stability, reduces the risk of postoperative delirium, and leads to shorter ICU stay. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6020583/ /pubmed/29962634 http://dx.doi.org/10.4103/aer.AER_46_18 Text en Copyright: © 2018 Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Sheikh, Tufail Ahmad
Dar, Bashir Ahmad
Akhter, Nihida
Ahmad, Nadeem
A Comparative Study Evaluating Effects of Intravenous Sedation by Dexmedetomidine and Propofol on Patient Hemodynamics and Postoperative Outcomes in Cardiac Surgery
title A Comparative Study Evaluating Effects of Intravenous Sedation by Dexmedetomidine and Propofol on Patient Hemodynamics and Postoperative Outcomes in Cardiac Surgery
title_full A Comparative Study Evaluating Effects of Intravenous Sedation by Dexmedetomidine and Propofol on Patient Hemodynamics and Postoperative Outcomes in Cardiac Surgery
title_fullStr A Comparative Study Evaluating Effects of Intravenous Sedation by Dexmedetomidine and Propofol on Patient Hemodynamics and Postoperative Outcomes in Cardiac Surgery
title_full_unstemmed A Comparative Study Evaluating Effects of Intravenous Sedation by Dexmedetomidine and Propofol on Patient Hemodynamics and Postoperative Outcomes in Cardiac Surgery
title_short A Comparative Study Evaluating Effects of Intravenous Sedation by Dexmedetomidine and Propofol on Patient Hemodynamics and Postoperative Outcomes in Cardiac Surgery
title_sort comparative study evaluating effects of intravenous sedation by dexmedetomidine and propofol on patient hemodynamics and postoperative outcomes in cardiac surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020583/
https://www.ncbi.nlm.nih.gov/pubmed/29962634
http://dx.doi.org/10.4103/aer.AER_46_18
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