Key result
Postoperative sedation with dexmedetomidine reduced the incidence of atrial fibrillation compared to propofol (0.9% vs 13%, P=0.001) after cardiac surgery.
Why the study?
Atrial fibrillation is a common post-cardiac surgery complication with deleterious effects on morbidity and mortality, prompting a comparison between dexmedetomidine and propofol for its reduction.
Does dexmedetomidine infusion reduce the incidence of atrial fibrillation compared to propofol in patients after cardiac surgery?
RCT (n=98)
No
Does dexmedetomidine infusion reduce the incidence of atrial fibrillation compared to propofol in patients after cardiac surgery?
Absolute Event Rate: 0.9% vs 13%
p-value: p=0.001
Postoperative sedation with dexmedetomidine significantly reduces the incidence of atrial fibrillation and ICU length of stay compared to propofol in cardiac surgery patients.
Dexmedetomidine may lower post-cardiac surgery AF incidence versus propofol; leaves open confirmation in larger RCTs before practice change.
Objectives Atrial fibrillation is a common complication associated with cardiac surgery after cardiopulmonary bypass with a deleterious effect on morbidity and mortality. The current study aimed to compare between dexmedetomidine and propofol in reducing atrial fibrillation after cardiac surgery.Design A randomized prospective cohort study.Setting Conducted in Alexandria main university hospital.Participants 98 patients of either sex ASA II physical status aged 40–60 years.Interventions All patients were subjected to either propofol or dexmedetomidine infusion after cardiac surgery according to the assigned group.Measurements and Main Results The patients were divided into two groups where first group received dexmedetomidine infusion as postoperative sedation and the second group received propofol infusion. Both groups were assessed for incidence of atrial fibrillation, hypotension and length of intensive care stay. Incidence with atrial fibrillation was 0.9% in dexmedetomidine group vs. 13% in propofol group (P = 0.001) and intensive care stay was prolonged in propofol group 4.6 ± 1.2 day vs. 2.7 ± 1 for dexmedetomidine group (P = 0.002). There was no statistically significant difference between both groups regarding blood pressure or heart rate.Conclusion The use of dexmedetomidine for sedation after cardiac surgery was associated with a lower incidence of atrial fibrillation and hence decreased the duration of intensive care stay.
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Abdallah et al. (2022) conducted an RCT in Postoperative sedation after cardiac surgery (n=98). Dexmedetomidine vs. Propofol was evaluated on Incidence of atrial fibrillation (p=0.001). Postoperative sedation with dexmedetomidine reduced the incidence of atrial fibrillation compared to propofol (0.9% vs 13%, P=0.001) after cardiac surgery.
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