Literature DB >> 25617159

Effects of dexmedetomidine and propofol on sedation in patients after coronary artery bypass graft surgery in a fast-track recovery room setting.

Yucel Karaman1, Burcin Abud, Zeki Tuncel Tekgul, Meltem Cakmak, Murside Yildiz, Mustafa Gonullu.   

Abstract

PURPOSE: We aim to compare the effects of propofol and dexmedetomidine infusions on extubation times, hemodynamic and respiratory functions, complication rates and patient satisfaction scores in patients undergoing coronary artery bypass graft (CABG) surgery using a fast-track anesthesia regimen for early extubation.
METHODS: We enrolled 64 patients who underwent CABG surgery. Dexmedetomidine (min 0.2 µg/kg/h-max 1.0 µg/kg/h) and propofol (min 1.0 mg/kg/h-max 3.0 mg/kg/h) infusion doses were titrated to give bispectral index values between 60 and 90 and a Ramsay sedation score (RSS) between 3 and 4. Postoperative extubation times, patient satisfaction and postoperative adverse events were recorded.
RESULTS: The mean times to extubation were 265.94 ± 43.1 min for the dexmedetomidine group and 322.52 ± 39.2 min for the propofol group (P < 0.001). In all recordings, RSS median values for the propofol group were significantly lower than the dexmedetomidine group (P < 0.05). There were no differences in the incidence of postoperative adverse events between the dexmedetomidine and propofol groups. There was a statistically significant difference between patient satisfaction median values of the two groups-7 (5-9) and 9 (7-10) (min-max) for the propofol and dexmedetomidine groups, respectively (P < 0.001).
CONCLUSION: Our results show that dexmedetomidine can easily be preferred over propofol in fast-track cardiac anesthesia due to its significant advantages of shorter extubation time and higher postoperative patient satisfaction scores.

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Year:  2015        PMID: 25617159     DOI: 10.1007/s00540-015-1975-2

Source DB:  PubMed          Journal:  J Anesth        ISSN: 0913-8668            Impact factor:   2.078


  17 in total

1.  Pharmacokinetics of dexmedetomidine infusions for sedation of postoperative patients requiring intensive caret.

Authors:  R M Venn; M D Karol; R M Grounds
Journal:  Br J Anaesth       Date:  2002-05       Impact factor: 9.166

Review 2.  Patients' experiences of being in an intensive care unit: a select literature review.

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Review 3.  Remifentanil in cardiac surgery: a meta-analysis of randomized controlled trials.

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Journal:  J Cardiothorac Vasc Anesth       Date:  2011-08-05       Impact factor: 2.628

Review 4.  Propofol: a review of its use in intensive care sedation of adults.

Authors:  Kate McKeage; Caroline M Perry
Journal:  CNS Drugs       Date:  2003       Impact factor: 5.749

5.  A comparison of propofol and dexmedetomidine for intravenous sedation: a randomized, crossover study of the effects on the central and autonomic nervous systems.

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6.  ICU sedation after coronary artery bypass graft surgery: dexmedetomidine-based versus propofol-based sedation regimens.

Authors:  Daniel L Herr; S T John Sum-Ping; Michael England
Journal:  J Cardiothorac Vasc Anesth       Date:  2003-10       Impact factor: 2.628

Review 7.  Clinical benefits of dexmedetomidine versus propofol in adult intensive care unit patients: a meta-analysis of randomized clinical trials.

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Review 8.  [Dexmedetomidine].

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9.  Can dexmedetomidine be a safe and efficacious sedative agent in post-cardiac surgery patients? a meta-analysis.

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  16 in total

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Review 3.  Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery.

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4.  Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial.

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Review 5.  Dexmedetomidine Based Sedation for Post-surgery Critically Ill Adults: A Meta-analysis of Randomized Controlled Trials.

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6.  Does dexmedetomidine have an antiarrhythmic effect on cardiac patients? A meta-analysis of randomized controlled trials.

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7.  Experienced Use of Dexmedetomidine in the Intensive Care Unit: A Report of a Structured Consensus.

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Journal:  Turk J Anaesthesiol Reanim       Date:  2017-06-01

8.  The Influence of Perioperative Dexmedetomidine on Patients Undergoing Cardiac Surgery: A Meta-Analysis.

Authors:  Jun Geng; Ju Qian; Hao Cheng; Fuhai Ji; Hong Liu
Journal:  PLoS One       Date:  2016-04-06       Impact factor: 3.240

9.  Dexmedetomidine sedation reduces atrial fibrillation after cardiac surgery compared to propofol: a randomized controlled trial.

Authors:  Xu Liu; Kai Zhang; Wei Wang; Guohao Xie; Xiangming Fang
Journal:  Crit Care       Date:  2016-09-21       Impact factor: 9.097

Review 10.  Can dexmedetomidine reduce atrial fibrillation after cardiac surgery? A systematic review and meta-analysis.

Authors:  Zhipeng Zhu; Hongmei Zhou; Yunjian Ni; Cheng Wu; Caijun Zhang; Xiaoyan Ling
Journal:  Drug Des Devel Ther       Date:  2018-03-12       Impact factor: 4.162

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