Jihong Xu, Chunji Jin, Xiaopeng Cui, Zhou Jin
(Department of Anesthesiology, General Hospital of Shenyang Military Region, Shenyang, Liaoning, China (mainland))
Med Sci Monit 2015; 21:2125-2133
Adequate sedation is important in the post-anesthesia care unit (PACU) following uvulopalatopharyngoplasty (UPPP) to ensure patient comfort and decrease the duration of mechanical ventilation (MV), PACU stay, and bleeding. This study aimed to compare dexmedetomidine and propofol as sedatives after UPPP in the PACU.
MATERIAL AND METHODS: We randomized 124 mechanically ventilated adults following UPPP who were managed in the PACU of the General Hospital of the Shenyang Military Region between January 2014 and June 2014, to receive either dexmedetomidine or propofol. The patients in the propofol group received an infusion of propofol (3 mg/kg/h) titrated up to 6 mg/kg/h to attain a Ramsay sedation score ≥4. The dexmedetomidine group patients received 1.0 μg/kg of dexmedetomidine over a period of 10 minutes and then 0.5 to 1.0 μg/kg/h infusion to maintain a Ramsay sedation score ≥4.
RESULTS: Bispectral index (BIS) values were significantly lower in the dexmedetomidine group than in the propofol group at Ramsay sedation scores of 4 and 5. The mean times to spontaneous breathing, waking, and extubation were shorter in the dexmedetomidine group. Tramadol requirement was significantly reduced in the dexmedetomidine group (P<0.05). Incidence of cough during the extubation process in the propofol group was higher than in the dexmedetomidine group. After extubation, Bruggemann comfort scale (BCS) and Rass agitation scores (RASS) were decreased in the dexmedetomidine-sedated patients.
CONCLUSIONS: Dexmedetomidine provides safe and effective sedation for post-UPPP surgical patients and significantly reduces the use of analgesics, with minimal adverse effects.
Keywords: Conscious Sedation - methods, Adult, Dexmedetomidine - adverse effects, Female, Humans, Hypnotics and Sedatives - adverse effects, Male, Middle Aged, Palate, Soft - surgery, Pharynx - surgery, Postoperative Care, Propofol - adverse effects, Retrospective Studies, Sleep Apnea, Obstructive - surgery, Uvula - surgery