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HERDIN Record #: NCR-PHC-18091910580616 Submitted: 19 September 2018 Modified: 19 September 2018

A comparison between Dexemetomidine and Midazolam as post operative sedative in pediatric patients after cardiac surgery.

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Background: Dexmedetomidine is a highly specific and selective alpha-2-adrenergic agonist that provides sedation, anxiolysis and analgesia. It has been studied in cardiac patients as an adjunctive sedative together with midazolam. This study would like to compare the effects of the use of midazolam and dexmedetomidine as post operative sedative in patients who underwent cardiac surgery.


Method: In a retrospective cohort study, 71 pediatric patients aged 1-18 years old, ungergoing cardiac surgery who have been given post operative sedation were selected. Demographic data such as age, sex, body weight, height, body surface area, type of congenital defect and intraoperative data, such as surgical procedure done, cardiopulmonary bypass time, aortic cross clamp time were recorded. Inotropic score, length of sedation , length of mechanical ventilator time, occurrence of reintubation, and need for adjunctive sedative agent were also noted.


Results: The groups of children were comparable in properties of sex, types of surgical procedure, cardiopulmonary bypass time, and aortic cross clamp/ischemic time. However, the dexmedetomidine group was about six years older than the midazolam group (10.7 ± 3.9 vs. 4.9 ± 3.7 years), and thus, their mean weight, height, and BSA were also significantly greater. Though there was an absolute difference in proportions of usage of adjunctive sedative between the two groups (dexmedetomidine group 35.3% vs. midazolam group 35.2%), the evidence was insufficient to prove a significant difference (P=.993). In both groups of patients, the preferred supplemental analgesic was propofol.


Likewise, our data was not able to support significant intergroup differences in lengths of sedation, duration on mechanical ventilation, post-op inotropic scores, and rates of reintubation.
Conclusion: Midazolam and dexmedetomidine have been suggested as post operative sedative agent. However, this study does not show any significant difference among the two agents. More studies are recommended to show the difference among the two agents.


Conclusion: Midazolam and dexmedetomidine have been suggested as post operative sedative agent. However, this study does not show any significant difference among the two agents. More studies are recommended to show the difference among the two agents.

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Research Project
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Philippine Heart Center Medical Library PHC.R.053.15 Fulltext Print Format
 

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