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

Abstract

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.