Division of Cardiothoracic Anesthesia, Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Cardiothorac Vasc Anesth. 2024 Oct;38(10):2324-2333. doi: 10.1053/j.jvca.2024.06.019. Epub 2024 Jun 18.
To compare the analgesic and sleep quality effects of dexmedetomidine infusion versus placebo in patients undergoing cardiac surgery with ultra-fast track extubation.
The randomized, double-blind clinical trial study.
At a single academic center hospital.
We included patients aged 25 to 65 scheduled for elective cardiac surgery under general anesthesia with cardiopulmonary bypass from October 2021 to December 2022.
After immediate extubation in the operating room, the patients who were allocated at first after providing their consent to either the dexmedetomidine group (Dex) or the placebo group (Placebo) received continuous infusion of dexmedetomidine (0.2 μg/kg/h) or saline for 12 hours postoperatively.
The groups' demographic and perioperative variables were not statistically significant. Total morphine consumption in milligrams at 12 and 24 hours after administered study drug, total sleep time in hours by BIS value ≤85, and sleep quality with the Richard-Campbell Sleep Questionnaire were compared. The analysis included 22 Dex and 23 Placebo patients. The consumption of morphine was not statistically different between the Dex and Placebo groups at 12 and 24 hours (p = 0.707 and p = 0.502, respectively). The Dex group had significantly longer sleep time (8.7 h [7.8, 9.5]) than the Placebo group (5.8 h [2.9, 8.5]; p = 0.007). The Dex group also exhibited better sleep quality (7.9 [6.7, 8.7] vs 6.6 [5.2, 8.0]; p = 0.038).
Sedation with low-dose dexmedetomidine infusion for ultra-fast track extubation following cardiac surgery enhances sleep duration and quality.
比较心脏手术患者术后行超快速脱机时，输注右美托咪定与安慰剂的镇痛和睡眠质量效果。
随机、双盲临床试验研究。
单家学术中心医院。
纳入 2021 年 10 月至 2022 年 12 月期间接受全身麻醉联合体外循环下择期心脏手术的年龄 25-65 岁的患者。
在手术室立即拔管后，根据同意情况，将患者按先后顺序随机分配至右美托咪定组（Dex）或安慰剂组（Placebo），术后 12 小时内接受右美托咪定（0.2μg/kg/h）或生理盐水持续输注。
两组患者的人口统计学和围手术期变量无统计学差异。比较两组患者在使用研究药物后 12 小时和 24 小时时的吗啡总消耗量（毫克）、BIS 值≤85 时的总睡眠时间（小时）以及采用 Richard-Campbell 睡眠问卷评估的睡眠质量。分析纳入了 22 名 Dex 组和 23 名 Placebo 组患者。Dex 组和 Placebo 组在 12 小时和 24 小时时的吗啡消耗量无统计学差异（p=0.707 和 p=0.502）。Dex 组的睡眠时间明显长于 Placebo 组（8.7h[7.8,9.5] vs 5.8h[2.9,8.5]；p=0.007）。Dex 组的睡眠质量也更好（7.9[6.7,8.7] vs 6.6[5.2,8.0]；p=0.038）。
心脏手术后行超快速脱机时输注小剂量右美托咪定镇静可延长睡眠时间并改善睡眠质量。
