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Beneficial aspect of dexmedetomidine as a postoperative sedative for cardiac surgery
Anesth Pain Med 2018;13(1):65-71
Published online January 31, 2018
© 2018 Korean Society of Anesthesiologists.

Seokhoon Kim1, Kye-Min Kim1, Sangseok Lee1, Byung Hoon Yoo1 , Sinae Kim2, Sung Joon Park2, Jaehoon Lee2, and Euisuk Chung2
Departments of 1Anesthesiology and Pain Medicine, 2Cardiothoracic Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
Correspondence to: Byung Hoon Yoo, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 01757, Korea
Tel: 82-2-950-1330
Fax: 82-2-950-1313
E-mail: twowind@paik.ac.kr
ORCID
http://orcid.org/0000-0002-1958-8380
Received June 5, 2017; Revised September 14, 2017; Accepted September 14, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
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.
Key Words : Conscious sedation, Coronary artery bypass, Dexmedetomidine, Midazolam, Postoperative care.


January 2018, 13 (1)
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