Azarfarin Rasoul, Ziaei Fard Mohsen, Ghadimi Maryam, Chaibakhsh Yasmin, Yousefi Marziyeh
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
J Cardiovasc Thorac Res. 2024;16(3):156-163. doi: 10.34172/jcvtr.33086. Epub 2024 Sep 20.
Sleep quality is the main concern of patients after cardiac surgery. We compared the effect of two routinely used sedatives on the sleep quality of patients admitted to the intensive care unit (ICU) after cardiovascular surgery.
It is a prospective, controlled, randomized clinical trial. A total of 120 patients, after cardiac surgery were enrolled. During extubating, patients were randomized into two groups: 60 patients received an infusion of dexmedetomidine (precede; 0.5 μg/kg/h), and 60 patients received 50 μg/kg/min propofol for 6 hours. Baseline characteristics were compared between the groups. The patients completed the St. Mary's Hospital Sleep Questionnaire, and the scores were compared between the groups.
The groups were not different in terms of demographics, underlying diseases, smoking/drug abuse/alcohol, number of vessels involved, history of non-cardiac surgery, and mean levels of serum parameters (>0.05). Most of the medications used were similar between the groups (>0.05), except calcium channel blockers (more frequently used in the propofol group [=0.027). The details of surgery were not statistically significant different (>0.05); but, the mean volume of platelet received after the surgery was higher in propofol group (=0.03). The propofol group had less problems with last night's sleep (0 vs 0.1±0.66), felt more clear-headed (4.9±0.6 vs 4.68±0.58, were more satisfied with their last night's sleep (52.1% vs 47.9%), but spent more time getting into sleep (0.38±1.67 vs 0 ) (<0.5).
The sleep quality of patients under the influence of propofol seemed to be better than dexmedetomidine after cardiac surgery.
睡眠质量是心脏手术后患者主要关心的问题。我们比较了两种常用镇静剂对心血管手术后入住重症监护病房（ICU）患者睡眠质量的影响。
这是一项前瞻性、对照、随机临床试验。共纳入120例心脏手术后患者。在拔管期间，患者被随机分为两组：60例患者接受右美托咪定输注（首剂；0.5μg/kg/h），60例患者接受丙泊酚50μg/kg/min输注6小时。比较两组的基线特征。患者完成圣玛丽医院睡眠问卷，并比较两组得分。
两组在人口统计学、基础疾病、吸烟/药物滥用/饮酒、受累血管数量、非心脏手术史和血清参数平均水平方面无差异（>0.05）。两组使用的大多数药物相似（>0.05），除钙通道阻滞剂（在丙泊酚组使用更频繁[=0.027]）。手术细节无统计学显著差异（>0.05）；但丙泊酚组术后接受的血小板平均量更高（=0.03）。丙泊酚组昨晚睡眠问题更少（0比0.1±0.66），感觉头脑更清醒（4.9±0.6比4.68±0.58），对昨晚睡眠更满意（52.1%比47.9%），但入睡时间更长（0.38±1.67比0）（<0.5）。
心脏手术后，丙泊酚作用下患者的睡眠质量似乎优于右美托咪定。
