Effects of dexmedetomidine and propofol on sedation in patients after coronary artery bypass graft surgery in a fast-track recovery room setting

Karaman, Yücel; Abud, Burçin; Tekgül, Zeki Tuncel; Çakmak, Meltem; Yildiz, Murside; Gönüllü, Mustafa

doi:10.1007/s00540-015-1975-2

Cited by 45 publications

(51 citation statements)

References 16 publications

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“…Further review of the abstract and full text of the remaining 91 articles was followed. At last, the final 18 RCTs [ 2 , 20 – 22 , 24 , 29 – 41 ] were included in this systematic review. Total of 1730 patients undergoing cardiac surgery were involved in these studies, including 865 cases in the dexmedetomidine group, and 865 cases in the control group (any treatment without dexmedetomidine).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies [ 29 , 33 , 36 , 37 , 40 , 41 ] compared the rates of tachycardia of dexmedetomidine versus control (any treatment without dexmedetomidine) during surgery. There was no statistical heterogeneity (P = 0.91, I 2 = 0%) in each study, and a fixed effect model was used.…”

Section: Resultsmentioning

confidence: 99%

“…Eight [ 20 , 22 , 30 – 32 , 37 – 39 ] and nine [ 2 , 22 , 24 , 29 , 32 , 35 , 38 , 39 , 41 ] literatures compared the duration of ICU stay and surgery in patients treated with dexmedetomidine versus control group (any treatment without dexmedetomidine) during and after surgery ( Fig 7A and 7B ). There was significant heterogeneity among these studies (P<0.05), so the random effect model was introduced.…”

Section: Resultsmentioning

confidence: 99%

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The efficacy and safety of dexmedetomidine in cardiac surgery patients: A systematic review and meta-analysis

Wang

Niu

et al. 2018

PLoS ONE

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This study aimed to evaluate the efficacy and safety of dexmedetomidine versus any other treatment without dexmedetomidine in patients who have undergone cardiac surgery. Electronic databases including PubMed, Embase, and Cochrane Library were systematically searched without limitations of language and publication time. Randomized controlled trials (RCTs) aiming to evaluate the efficacy and safety of dexmedetomidine versus any other treatment without dexmedetomidine in patients that have undergone cardiac surgery were selected. Endpoints such as hemodynamic indexes and adverse events in eligible studies were extracted by two researchers, independently. The data was analyzed using RevMan 5.3 and Stata 11.0 software. A total of 18 RCTs met the inclusion criteria, involving 1730 patients. Compared to control (any treatment without dexmedetomidine), dexmedetomidine showed a pooled mean difference (MD) of -14.46 [95% confidence interval(CI): -24.69, -4.23; p<0.01] for systolic arterial pressure, a standardized mean difference (SMD) of -1.74 for mean arterial blood pressure (95% CI: -2.80, -0.68; P < 0.01), -2.12 (95%CI: -3.23, -1.00; p<0.01) for heart rate, and combined odds ratio (OR) of 0.22 (95%CI: 0.11, 0.44; p<0.01) for tachycardia, 3.44 (95%CI: 1.95, 5.96; p<0.01) for bradycardia, 0.74 (95%CI: 0.49, 1.12; p>0.05) for atrial fibrillation, and 0.99 (95%CI: 0.51, 1.90; p>0.05) for hypotension. In addition, dexmedetomidine could reduce time of surgery and stay in intensive care units, improve delirium with good safety. Our study shows clinical application of dexmedetomidine in cardiac surgery patients can reduce risks of abnormal hemodynamics with good safety.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The efficacy and safety of dexmedetomidine in cardiac surgery patients: A systematic review and meta-analysis

Wang

Niu

et al. 2018

PLoS ONE

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“…Nevertheless, we found that time to discharge from the PACU tended to be lower in dexmedetomidine group compared to propofol group. In addition, Karaman et al demonstrated that the mean times to extubation were significantly lower in the dexmedetomidine group than in the propofol group in patients undergoing coronary artery bypass graft surgery. Further prospective studies are required to assess the discharge time from the hospital in dexmedetomidine propofol group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of sedation with dexmedetomidine vs propofol during hysteroscopic surgery: Single-centre randomized controlled trial

et al. 2019

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Summary What is known and objective The most appropriate sedative agent for conscious sedation in minor hysteroscopic surgeries is still unclear. Dexmedetomidine a sedative and analgesic agent, may be appropriate for outpatient procedures. The aim of our study was to compare the sedative, analgesic and hemodynamic effects of dexmedetomidine vs propofol in combination with fentanyl and midazolam in patients undergoing minor hysteroscopy surgery. Methods Sixty patients undergoing minor hysteroscopic surgery were randomized to receive either dexmedetomidine (n = 30) or propofol (n = 30) groups. Dexmedetomidine was infused at 1 µg/kg for 10 minutes followed by a 0.7 µg/kg/h maintenance infusion. Propofol was infused a bolus of 1.5 mg/kg followed by a 2.5 mg/kg/h maintenance infusion. Fentanyl 1.5 mcg/kg and midazolam 0.03 mg/kg were performed to all patients as premedication therapy before the hysteroscopic surgery. Post‐operative pain score was assessed with visual analogue scale (VAS). Hemodynamic variables and Riker Sedation‐Agitation Scale (SAS) scores were recorded for all patients. Results Mean arterial pressure and heart rate in the dexmedetomidine group were significantly lower than in propofol group, whereas SpO2 was similar between two groups. In addition, post‐operative Riker SAS and VAS scores were significantly lower in dexmedetomidine group than in the propofol group. Bradycardia, hypotension and serious adverse events did not occur in any patients. What is new and conclusion Dexmedetomidine was associated with better analgesia and lower post‐operative pain score than propofol in patients undergoing hysteroscopic surgery. However, arterial pressure and heart rate should be more closely monitored in patients received dexmedetomidine.

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“…As the safety of childhood anesthesia exposure in terms of neurodevelopment remains a highly controversial topic, the result of this meta-analysis has since been widely cited in the medical literature. At the writing of this editorial, six articles published in 2015 from Asian countries other than Japan [6][7][8][9][10] have been cited more than 5 times each. JA has thus served as a bridge between Asia and the global anesthesia community.…”

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confidence: 99%

The role of Journal of Anesthesia as a flagship anesthesia journal in Asia

Kuratani

2017

J Anesth

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Effects of dexmedetomidine and propofol on sedation in patients after coronary artery bypass graft surgery in a fast-track recovery room setting

Abstract: Our results show that dexmedetomidine can easily be preferred over propofol in fast-track cardiac anesthesia due to its significant advantages of shorter extubation time and higher postoperative patient satisfaction scores.

Cited by 45 publications

References 16 publications

The efficacy and safety of dexmedetomidine in cardiac surgery patients: A systematic review and meta-analysis

The efficacy and safety of dexmedetomidine in cardiac surgery patients: A systematic review and meta-analysis

Comparison of sedation with dexmedetomidine vs propofol during hysteroscopic surgery: Single-centre randomized controlled trial

The role of Journal of Anesthesia as a flagship anesthesia journal in Asia

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