Randomized single-blinded study comparing sedation effectiveness and hemodynamic stability of remifentanil vs dexmedetomidine infusion for electrophysiology procedures in patients of National Heart Institute cathlab.
Rozaini Hassan, Azlee Abdul Mutalib, Chen Yi Shang, Nirpal Singh Sachdev, Farkad Abdul Rahman, Esther Siew Lee Ling
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引用次数: 0
Abstract
Background: While studies comparing the effectiveness of remifentanil and dexmedetomidine are prevalent in other nations, using remifentanil alone is uncommon in Malaysia. This research aims to evaluate the effectiveness of sedation with remifentanil or dexmedetomidine infusion in monitored anesthesia care for electrophysiology procedures.
Methods: This study is a single-center, single-blinded, prospective randomized clinical study. One hundred twenty patients were randomized into two groups (remifentanil vs dexmedetomidine). Demographic characteristics and clinical outcomes, including level of sedation, vital signs, and patient satisfaction were monitored and recorded.
Results: Group R showed a higher mean observer's assessment of alertness/sedation score (3.9 ± 0.7 vs 3.6 ± 0.8; p = 0.008), mean arterial pressure (92.0 ± 12.0 vs 83.0 ± 13.0 mmHg; p < 0.001), heart rate (82.0 ± 20.0 vs 73.0 ± 18.0 beats/min; p = 0.006), systolic blood pressure (139.0 ± 16.0 vs 123.0 ± 17.0 mmHg; p < 0.001) and diastolic blood pressure (75.0 ± 13.0 vs 69.0 ± 14.0 mmHg; p = 0.009) than Group D. Oxygen saturation (99.0 ± 1.0%; p = 0.220) and respiration rate (16.0 ± 3.0 breaths/min; p = 0.361) for both groups were the same. Adverse events, including hypotension, bradycardia, and respiratory depression were observed in both groups. Both groups gave positive responses ranging from fair to good for patient satisfaction.
Conclusion: Dexmedetomidine is a better choice of anesthesia as it was associated with a higher level of sedation, more stable hemodynamics, lower incidence of adverse events, and better patient satisfaction.
期刊介绍:
The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.