INFLUENCE OF SEDATION STRATEGY ON THE PATIENT’S HEMODYNAMIC STATUS IN THE EARLY POSTOPERATIVE PERIOD AFTER CARDIAC SURGERIES WITH CARDIAC PULMONARY BYPASS. COMPARISON OF PROPOFOL-BASED, DEXMEDETOMIDINE-BASED SEDATION OR THEIR COMBINATION

Abstract

Introduction: Patient sedation in the intensive care unit after cardiac surgeries with cardiac pulmonary bypass (CPB) has an element of negative impact on the hemodynamic status of the patient. Vasoplegia caused by the use of of artificial blood circulation in combination with the use of hypnotics can lead to a large number of complications and increase the duration of the patient’s stay in the conditions of the intensive care unit. Purpose: to compare the effect on the hemodynamic status of patients after cardiac surgery with the use of artificial blood circulation 3 drugs for sedation: propofol, dexmedetomidine and their combination. Materials and methods: A randomized controlled parallel study was conducted. The study included 356 patients over 18 years of age who underwent cardiac surgical treatment with CBP. Statistical data processing was carried out on the basis of Prism 9.0 software. Results and discussion: The frequency of hemodynamic disturbances that required vasopressors in the early postoperative period was 35.79% (n= 34) in the propofol group (n= 95) ,12.35% (n = 10) in the group of the combination of propofol and dexmedetomidine (n= 81), 31.25% (n=5) dexmedetomidine sedation group (n= 16). (p=0.0011) Conclusions: Vasopressors infusion has been less common in the propofol and dexmedetomidine combination group (p = 0.0011).