Objective: To compare the hemodynamics changes, intraoperative awareness and postoperative delirium after combined administration of dexmedetomidine plus propofol versus propofol alone in cardiac surgical patients. Study Design: Randomized Clinical Trial. Setting: Cardiac Center, Bahawal Victoria Hospital, Bahawalpur. Period: 1st December 2018 to January 2020. Material & Methods: Sixty-two (62) patients who underwent different cardiac surgical procedures were included in the study. Patients were randomly divided in group 1 {Dexmedetomidine (DEX) +Propofol} and group 2 {propofol alone}. Induction in group 1 was done by loading dose of DEX (0.7 microgram/kg) while induction in group 2 was done by Lignocaine 1.5 mg/kg. Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP) were recorded at different time intervals. Intraoperative awareness and post-operative delirium was also assessed. Results: All hemodynamic parameters (HR, SAP, DAP, MAP) were statistically significant lower in group 1 in comparison to group 2 at different intervals indicating a more stable hemodynamic profile in group 1. End tidal CO2, pH, and peak airway pressures were not statistically significant between both groups. Intra-operative awareness was diagnosed in 1 (3.2%) patients in group 1 and in 5 (16.1%) patients in group 2 (p-value 0.08). Delirium was diagnosed in 3 (9.6%) patients in group 1 and in only 1 (3.2%) patients in group 2 (p-value 0.30). Conclusion: Combined administration of DEX and propofol produces more stable hemodynamics, less intraoperative awareness but more incidence of delirium as compared to propofol alone in cardiac surgical patients.
Objective: To ascertain the safety and efficacy of concomitant administration of dexmedetomidine and propofol in maintaining myocardial protection and renal function integrity in comparison to propofol alone in adult cardiac surgical patients. Methodology: A randomized clinical trial was conducted at cardiac center Bahawalpur from June 2018 to January 2020. Study included 64 patients who underwent coronary artery bypass grafting (CABG). Two groups, DP (DEXMEDETOMIDINE (DEX) +Propofol) and P (Propofol alone) were made by allocating 32 patients in each group. Hemodynamic parameters (Heart rate, Diastolic blood pressure (DBP), systolic blood pressure (SBP) and mean arterial pressure (MAP) at different time intervals throughout the surgery were measured, pre and post-operative CKMB, any arrhythmias, events of tachycardia and bradycardia were recorded and renal parameters (urine output immediate post pump and 4 hours post pump, creatinine clearance of day 1 and day 2) were measured. Results: DP group showed stable hemodynamics with values of hemodynamic parameters were lesser and statistically significant than patients in group P (Heart rate (p<.05), DBP (P<.05), SBP (P<.05) and MAP (p<.05). Both groups showed insignificant difference in terms of incidence of arrhythmias (p=0.325), Post-operative CKMB (P=0.512), events of tachycardia (p=0.6) and bradycardia (p=0.5).Immediate post pump urine was statistically significant (p<.05), however, 4-hour post pump urine (p = 0.45), creatinine clearance of day 1 (p = 0.8) and day 2 (p =.092) were comparable. Conclusion: Concomitant administration of dexmedetomidine and propofol provide adequate cardioprotection by maintaining stable hemodynamics in comparison to propofol alone, however they did not prove to be effective renoprotective agents.
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