[Effects of dexmedetomidine hydrochloride on postoperative sedation in cardiovascular surgery].

ABSTRACT

BACKGROUND: Postoperative assessment of brain damage in cardiovascular surgery is often obscured by sedatives. Therefore, early postoperative detection of brain attack and its treatment are also hampered. A newly approved sedative, dexmedetomidine hydrochloride has weak analgesic effect and no respiratory depressive effect. These characteristics allow early assessment of brain damage after surgery. In this report, we compared 2 sedatives, propofol and dexmedetomidine hydrochloride, in cardiovascular settings. SUBJECT AND METHODS: Both sedatives were initiated right after admission to the intensive care unit (ICU), followed by titrimetric method targeting for the sedation agitation scale (SAS) from 1 to 4. Thirty-five cases were included in dexmedetomidine hydrochloride group (DEX group) and 16 cases were included in propofol group (Prop group). RESULTS: Preoperative and operative demographic data were the same between the 2 groups. Conversion rate to another sedatives, and incidence of vasopressor or hypotensor use were both in the same proportion in both groups. Intubated time was the same in both groups. Both systolic and diastolic blood pressures were kept lower in DEX group than Prop group until 8 hours after ICU admission. Other hemodynamic measurements, heart rate, pulmonary artery pressure and cardiac index showed no statistical difference. SAS and Ramsay score were better in DEX group early after ICU admission, and remained better until 10 hours later. CONCLUSION: Dexmedetomidine hydrochloride has no major hemodynamic nor other side effects after cardiovascular surgery. Dexmedetomidine hydrochloride could be used as an effective agent for postoperative sedation and analgesia in cardiovascular settings.