Analgesic Effect and Sleep Quality of Low-Dose Dexmedetomidine in Cardiac Surgical Patients After Ultrafast-Track Extubation: A Randomized Clinical Tria
ศรัญญา เลิศโกวิทย์, Kamheang Vacharaksa, Chaowanan Khamtuikrua, Angsu Chartrungsan, Nipaporn Sangarunakul, Aphichat Suphathamwit*
Division of Cardiothoracic Anesthesia, Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700 Thailandl; Email: [email protected]
บทคัดย่อ
Objective
To compare the analgesic and sleep quality effects of dexmedetomidine infusion versus placebo in patients undergoing cardiac surgery with ultra-fast track extubation.
Design
The randomized, double-blind clinical trial study.
Setting
At a single academic center hospital.
Participants
We included patients aged 25 to 65 scheduled for elective cardiac surgery under general anesthesia with cardiopulmonary bypass from October 2021 to December 2022.
Intervention
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.
Measurements and Main Results
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).
Conclusions
Sedation with low-dose dexmedetomidine infusion for ultra-fast track extubation following cardiac surgery enhances sleep duration and quality.
 
 
ที่มา
Journal of Cardiothoracic and Vascular Anesthesia ปี 2567, October ปีที่: 38 ฉบับที่ 10 หน้า 2324-2333
คำสำคัญ
Cardiac surgery, Dexmedetomidine, sleep quality, Analgesic effect, ultrafast-track extubation