Fast-Track Management in Off-Pump Coronary Artery Bypass Grafting: Dexmedetomidine Provides Rapid Extubation and Effective Pain Modulation.
Adrenergic alpha-2 Receptor Agonists
/ administration & dosage
Aged
Airway Extubation
Analgesics, Non-Narcotic
/ administration & dosage
Atrial Fibrillation
/ etiology
Coronary Artery Bypass, Off-Pump
/ adverse effects
Dexmedetomidine
/ administration & dosage
Female
Humans
Hypnotics and Sedatives
/ administration & dosage
Length of Stay
Male
Middle Aged
Pain, Postoperative
/ etiology
Propofol
/ administration & dosage
Recovery of Function
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Journal
The Thoracic and cardiovascular surgeon
ISSN: 1439-1902
Titre abrégé: Thorac Cardiovasc Surg
Pays: Germany
ID NLM: 7903387
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
pubmed:
29
8
2018
medline:
18
12
2019
entrez:
29
8
2018
Statut:
ppublish
Résumé
Dexmedetomidine (DEX) is a highly selective α-2 agonist with many desirable effects including analgesia, improvement of hemodynamic stability, and potential myocardial and renal protection. The aim of this study was to investigate the effect of DEX on patients undergoing off-pump coronary artery bypass (OPCAB) grafting with regard to less pain medication, earlier extubation, faster transfer to normal ward, and cardiac protection. From January 2012 to March 2015, 464 patients receiving OPCAB were included for retrospective analysis. After propensity matching (1:1), two groups (DEX vs. propofol, In the DEX group, less use of pain medication in the initial phase at intensive care unit was observed. During the first 2 hours, DEX patients received more nicomorphine (DEX 8 ± 3.2 mg vs. propofol 6 ± 4 mg, Early postoperative DEX application supports the fast-track strategy in patients after OPCAB through enabling rapid extubation, effective pain control, and reduced occurrence of new-onset AF. We are confident to give precedence to DEX over propofol as the new routine medication during postoperative patient transfer.
Sections du résumé
BACKGROUND
BACKGROUND
Dexmedetomidine (DEX) is a highly selective α-2 agonist with many desirable effects including analgesia, improvement of hemodynamic stability, and potential myocardial and renal protection. The aim of this study was to investigate the effect of DEX on patients undergoing off-pump coronary artery bypass (OPCAB) grafting with regard to less pain medication, earlier extubation, faster transfer to normal ward, and cardiac protection.
PATIENTS AND METHODS
METHODS
From January 2012 to March 2015, 464 patients receiving OPCAB were included for retrospective analysis. After propensity matching (1:1), two groups (DEX vs. propofol,
RESULTS
RESULTS
In the DEX group, less use of pain medication in the initial phase at intensive care unit was observed. During the first 2 hours, DEX patients received more nicomorphine (DEX 8 ± 3.2 mg vs. propofol 6 ± 4 mg,
CONCLUSION
CONCLUSIONS
Early postoperative DEX application supports the fast-track strategy in patients after OPCAB through enabling rapid extubation, effective pain control, and reduced occurrence of new-onset AF. We are confident to give precedence to DEX over propofol as the new routine medication during postoperative patient transfer.
Identifiants
pubmed: 30153698
doi: 10.1055/s-0038-1668602
doi:
Substances chimiques
Adrenergic alpha-2 Receptor Agonists
0
Analgesics, Non-Narcotic
0
Hypnotics and Sedatives
0
Dexmedetomidine
67VB76HONO
Propofol
YI7VU623SF
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
450-457Informations de copyright
Georg Thieme Verlag KG Stuttgart · New York.
Déclaration de conflit d'intérêts
Disclosure The authors report no conflicts of interest in this work.