Author : Sangseok Lee
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)
Book Synopsis Clinical Impact of Continuous Dexmedetomidine Based Sedation in Coronary Artery Bypass Graft (CABG) Surgery Patients by : Sangseok Lee
Download or read book Clinical Impact of Continuous Dexmedetomidine Based Sedation in Coronary Artery Bypass Graft (CABG) Surgery Patients written by Sangseok Lee and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Goal of Study: This prospective, randomized, open-label, controlled study was designed to compare dexmedetomidine-based to midazolam-based sedation after coronary artery bypass graft (CABG) surgery in the cardiac intensive care unit. Materials and Methods: After approval of IRB and written informed consent, forty patients scheduled for elective CABG surgery were randomly assigned to receive midazolam (0.03-0.1 mg/kg i.v. bolus intermittently) or dexmedetomidine (0.7 u03bcg/kg/hr. i.v. continuously). The study drug was administered from the time of sternal closure until weaning from mechanical ventilator. An infusion rate of dexmedetomidine or additional dose of midazolam was determined based on maintaining a RASS (Richmond Agitation-Sedation Score) more than 3. We recorded sedation score, time to extubation, ICU stay time, hemodynamics with cardiac index, and various side effect every 2 hours. Results and Discussion: The patient treated with dexmedetomidine showed significantly lower level of sedation than midazolam (P=0.008, Fig. 1). Average times to spontaneous respiration (865u00b1181 min vs 884u00b1272 min, P=0.862), to weaning from mechanical ventilator (1,020u00b195 vs 973u00b1276 min, P=0.642), and to ICU staying (75u00b18 vs 69u00b18 hr, P=0.177) were similar between midazolam and dexmedetomidine group, respectively. The hemodynamic variables (MAP, cardiac index, pulmonary artery pressure and etc.) and incidence of side-effects (delirium, shivering, nausea, vomiting, and pain) did not differ between the groups. Conclusions: Sedation with dexmedetomidine 0.7 u03bcg/ kg/hr i.v. provide effective sedation for post-CABG surgical patients, in particular, who need a deeper level of sedation. Nevertheless, patients who received sedation with dexmedetomidine did not show delayed recovery and any other side effects.