A prospective randomized study to see the effects of combined administration of dexmedetomidine plus propofol versus propofol alone in cardiac surgical patients.

Abstract

Objective: To compare the hemodynamics changes, intraoperative awareness and postoperative delirium after combined administration of dexmedetomidine plus propofol versus propofol alone in cardiac surgical patients. Study Design: Randomized Clinical Trial. Setting: Cardiac Center, Bahawal Victoria Hospital, Bahawalpur. Period: 1^st December 2018 to January 2020. Material & Methods: Sixty-two (62) patients who underwent different cardiac surgical procedures were included in the study. Patients were randomly divided in group 1 {Dexmedetomidine (DEX) +Propofol} and group 2 {propofol alone}. Induction in group 1 was done by loading dose of DEX (0.7 microgram/kg) while induction in group 2 was done by Lignocaine 1.5 mg/kg. Heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP) were recorded at different time intervals. Intraoperative awareness and post-operative delirium was also assessed. Results: All hemodynamic parameters (HR, SAP, DAP, MAP) were statistically significant lower in group 1 in comparison to group 2 at different intervals indicating a more stable hemodynamic profile in group 1. End tidal CO₂, pH, and peak airway pressures were not statistically significant between both groups. Intra-operative awareness was diagnosed in 1 (3.2%) patients in group 1 and in 5 (16.1%) patients in group 2 (p-value 0.08). Delirium was diagnosed in 3 (9.6%) patients in group 1 and in only 1 (3.2%) patients in group 2 (p-value 0.30). Conclusion: Combined administration of DEX and propofol produces more stable hemodynamics, less intraoperative awareness but more incidence of delirium as compared to propofol alone in cardiac surgical patients.