Comparison between dexmedetomidine and propofol for sedation during mechanically ventilated patients after major intraabdominal surgeries: An observational study Kumar Neeraj1,*, Kumar Amarjeet2, Kumar Ashish3, Hussain Mumtaz4, Kumar Anil5 1Senior Resident, Dept. of Trauma & Emergency, All India Institute of Medical Sciences, Patna, Bihar 2Senior Resident, Dept. of Trauma & Emergency, All India Institute of Medical Sciences, Patna, Bihar 3Senior Resident, Dept. of Anaesthesiology, All India Institute of Medical Sciences, Patna, Bihar 4Associte Professor, Dept. of Anaesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India 5Assistant Professor, Dept. of Trauma & Emergency, All India Institute of Medical Sciences, Patna, Bihar *Corresponding Author: Email: neeraj.jlnmc@gmail.com
Online published on 24 September, 2018. Abstract Introduction Major complex intraabdominal surgeries which have prolonged intraoperative surgical duration and wide hemodynamic fluctuations so they required an elective mechanical ventilation in view of large fluid shift and massive blood loss. So such large group of patients for providing conscious sedation two most popular agents dexmedetomidine and propofol are being used because their mechanisms of action and pharmacokinetic properties are different. Aims and Objectives Primary aim of our study is to assess the duration of mechanical ventilation in both study group (D or P) following major intraabdominal surgery. The secondary aim was to evaluate total duration of intensive care unit as well as hospital stay, incidence of delirium and any additional sedative agent Materials and Methods All patients on arrival to the ICU and after fulfilling the inclusion and exclusion criteria following completion of major intraabdominal surgeries they were allocated, randomly using sealed envelopes techniques into two groups each comprising of 15 patients, to receive intravenous infusions of either dexmedetomidine or propofol and plan for elective mechanical ventilation. Statistical analysis All data's was statistically analysed using Minitab® 16 (Minitab, Inc., State College, PA) software. Results In our study variables like demographic profile, baseline hemodynamics and ASA status were comparable in both the study groups. Our study results showed that total duration of mechanical ventilation was much earlier in the dexmedetomidine group compared to propofol (7.62 hours vs. 11.23 hours, P <0.05) and found to be statistically significant (P < 0.05). Our study results also suggested that on comparing duration of stay in intensive care unit as well as in hospital, the dexmedetomidine group has much lesser stay in ICU as well as in hospital compared to propofol group and it was statistically not significant (P > 0.05). The incidence of delirium were more in patient receiving propofol group (6.6% vs. 20%, P = 0.346). Conclusion This study concluded that for any complex major intraabdominal surgeries dexmedetomidine has significant reduction in time on mechanical ventilation but no significant difference was seen in terms of incidence of delirium, duration of ICU or hospital stay and mortality. Top Keywords Major abdominal surgery, Sedation, Dexmedetomidine, Propofol. Top |