The aim of this work was to study the incidence of delirium after coronary artery bypass graft surgery, and to compare the effects of dexmedetomidine and propofol on the incidence of postoperative delirium in coronary artery bypass graft surgery patients.
A prospective, observational study was conducted on 180 consecutive patients undergoing off-pump or on-pump coronary artery bypass graft surgery. The patients were administered either intravenous dexmedetomidine (n = 90) or propofol (n = 90) after hemostasis was achieved, till they were ready for weaning from the ventilator. The Confusion Assessment Method was used to assess the incidence of postoperative delirium.
A total of 25 (13.8%) patients developed delirium after coronary artery bypass graft surgery. Sedation with dexmedetomidine was associated with a significantly reduced incidence of postoperative delirium (8.9% v 18.9% propofol, P = 0.049). Subgroup analyses showed reduced incidence of postoperative delirium in off-pump patients compared to on-pump coronary artery bypass graft patients (3.3% vs. 20%, P = 0.009 dexmedetomidine group and 11.6% vs. 33.3%, P = 0.047 propofol group respectively). The mean age of the patients who had delirium was significantly more (64.9 ± 8.1 years vs. 52.5 ± 5.8 years, P = 0.046) compared to those who did not have delirium.
Administration of dexmedetomidine-based sedation resulted in the reduced incidence of postoperative delirium compared to propofol-based sedation in patients after coronary artery bypass graft surgery.
这项工作的目的是研究冠状动脉搭桥手术后谵妄的发生率,比较右美托咪定和丙泊酚对冠状动脉旁路移植术患者术后谵妄发生率的影响。
有前景的,我们对180例接受非体外循环或体外循环冠状动脉旁路移植术的连续患者进行了观察性研究.患者止血后静脉注射右美托咪定(n=90)或丙泊酚(n=90),直到他们准备好从呼吸机上断奶.采用混淆评估法评估术后谵妄的发生率。
共有25例(13.8%)患者在冠状动脉旁路移植术后出现谵妄。右美托咪定镇静可显著降低术后谵妄发生率(8.9%v18.9%丙泊酚,P=0.049)。亚组分析显示,与体外循环冠状动脉旁路移植术患者相比,非体外循环患者术后谵妄的发生率降低(3.3%vs.20%,P=0.009右美托咪定组和11.6%vs.33.3%,分别P=0.047丙泊酚组)。谵妄患者的平均年龄明显高于(64.9±8.1岁与52.5±5.8年,P=0.046)与没有谵妄的人相比。
在冠状动脉搭桥术后患者中,与丙泊酚镇静相比,右美托咪定镇静降低了术后谵妄的发生率。