Key result
Sedation with propofol, dexmedetomidine, or both shows no difference in postoperative arrhythmias after cardiac surgery.
Why the study?
Data remain conflicting regarding the effect of commonly used sedative agents, specifically propofol and dexmedetomidine, on reducing postoperative arrhythmias after cardiac surgery.
Does dexmedetomidine or its combination with propofol reduce the frequency of postoperative arrhythmias compared to propofol alone in patients undergoing cardiac surgery with bypass?
RCT (n=194)
Simple randomization
No
Does dexmedetomidine or its combination with propofol reduce the frequency of postoperative arrhythmias compared to propofol alone in patients undergoing cardiac surgery with bypass?
In patients undergoing cardiac surgery with bypass, the choice of sedation strategy (propofol, dexmedetomidine, or their combination) did not significantly affect the incidence of postoperative arrhythmias.
Postoperative arrhythmia rates are unaffected by sedation regimen after cardiac surgery; confirms no advantage of dexmedetomidine or combination over propofol alone.
Introduction: Postoperative arrhythmias are a frequent problem after surgical interventions, both noncardiac and cardiac surgeries. A 20% higher frequency of rhythm disturbances occurs in patients after cardiac surgery. Postoperative arrhythmia has many variations. Such arrhythmias include atrial fibrillation, atrial flutter, ventricular arrhythmias, and bradyarrhythmias. There are many conflicting facts about the effect of sedative drugs, which are most often used at the moment: propofol, dexmedetomidine, on reducing the frequency of postoperative arrhythmias. Purpose: To analyze whether there is a difference in the frequency of postoperative arrhythmia in patients in different groups sedated with propofol, dexmedetomidine and their combination. Materials and methods: This is a randomized controlled parallel study. The study included 356 patients over 18 years of age who underwent cardiac surgeries operative treatment. 194 patients were analyzed. Statistical data processing was carried out on the basis of GraphPad Prism 9.0 software. Results: Of the total number of patients in the propofol sedation group without prior rhythm disturbance, in whom arrhythmia was detected in the postoperative period, n=13 patients were registered. In the dexmedetomidine sedation group, postoperative arrhythmia was observed in 8 patients, which is also 50 % of the total number of patients in this group. Among 8 patients in whom postoperative arrhythmia was registered, 5 patients did not have rhythm problems before surgery. Of the total number of patients in the group of sedation with a combination of drugs without previous rhythm disturbance, postoperative arrhythmia was detected in 19 patients. When analyzing the frequency of postoperative arrhythmias, no difference in the frequency of postoperative arrhythmias has been detected in all three sedation strategies (p=0.1107). Conclusions: According to the data we obtained, no difference was found in the frequency of postoperative arrhythmias in patients after cardiac surgery in any of the sedation groups (p=0.1107).
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PLECHYSTA et al. (2023) conducted an RCT in Cardiac surgery with cardiopulmonary bypass (n=194). Dexmedetomidine, propofol, or their combination vs. Active comparators (3-arm study) was evaluated on Frequency of postoperative arrhythmias (p=0.1107). Sedation with propofol, dexmedetomidine, or their combination showed no significant difference in the frequency of postoperative arrhythmias after cardiac surgery (p=0.1107).
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