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KMID : 1155520180130010065
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Anesthesia and Pain Medicine
2018 Volume.13 No. 1 p.65 ~ p.71
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Beneficial aspect of dexmedetomidine as a postoperative sedative for cardiac surgery
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Kim Seok-Hoon
Kim Kye-Min
Lee Sang-Seok
Yoo Byung-Hoon
Kim Sin-Ae
Park Sung-Joon
Lee Jae-Hoon
Chung Eui-Suk
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Abstract
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Background: The aim of this study was to compare the clinical outcomes of the sedative, analgesic, and hemodynamic effects of dexmedetomidine and midazolam for sedation after coronary artery bypass grafting (CABG).
Methods: The adult patients undergoing elective CABG surgery under general anesthesia were randomly assigned to the dexmedetomidine (DEX) and midazolam (MDZ) groups. From the time of the sternal closure, dexmedetomidine (0.5?0.7 μg/kg/h) was continuously administered (DEX group), and midazolam (0.03?0.1 mg/kg) was administered by bolus (MDZ group). To maintain the target sedation level (Richmond Agitation-Sedation Scale [RASS] range, ?2 to ?1) until extubation in the intensive care unit (ICU), continuous doses of dexmedetomidine were regulated and midazolam was administered intermittently. Sedation (RASS) and pain scores (visual analogue scale) and hemodynamic changes were recorded every two hours, until the end of the mechanical ventilation assistance after entering the ICU.
Results: The mean of the fraction within the target sedation level in each patient’s total sedation time was 41.0% in the DEX group and 20.7% in the MDZ group (P = 0.026). In the DEX group, the RASS (P < 0.001) and cardiac index were lower (P = 0.047) than those in the MDZ group, but the other hemodynamic parameters and pain scores were not different.
Conclusions: This study showed that post-operative infusion of dexmedetomidine maintained a stable sedation without side effects in patients who underwent CABG surgery.
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KEYWORD
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Conscious sedation, Coronary artery bypass, Dexmedetomidine, Midazolam, Postoperative care
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