Comparative Evaluation of Efficacy, Hemodynamic Stability and Recovery during Conscious Sedation with Dexmedetomidine or Propofol in Cardiac Catheterization Laboratory
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Background:Conscious sedation provides calm and cooperative patient for interventional procedures. We compared dexmedetomidineand propofolin combination with fentanylfor conscious sedation during cardiac catheterization of adult patients. Methods:Sixty patients of aged 30-60 years, American society of anaesthesiologist Grade II or III scheduled for cardiac catheterization were randomly divided in two groups of 30 each. Group D receiveddexmeditomidine1μg/kg i.v. over 10 mins followed by infusion dose of 0.5μg/kg/hr. Group Preceived propofol 100μg/kg i.v over 1 min followed by infusion dose of 50μg/kg/min. Fentanyl 1μg/kg was given toall patients.Ramsay’s sedation score(RSS),intra-operative hemodynamic parameter, modified Aldrete score(MAS), recovery time, patient and cardiologist satisfaction scores andside effects were recorded. The data was analyzed using Microsoft excel 2010 and SPSS v.16 software. Statistical significance was considered at p value <0.05. Results:The mean RSS score at 8 min in group D was significantly lower in comparison to group P(3.03±0.49 v/s 3.66±0.47min) (p=0.000).In group D there was significant decrease in heart rate during procedure compared to group P (p<0.05).The fall in mean blood pressurewas significantly more in group P (16.23% vs 3.2%). The oxygen saturation values during sedation were significantly lower in group P(94%) compared to group D(96%) (p<0.05). Thetimeto achieve MAS >8 was less in group Dcompared to group P(5.63±1.40 v/s 13.93±3.11 min., p=0.001).Patient and cardiologist satisfaction scores were more with dexmedetomidine. Conclusion: Dexmedetomidine in combination with fentanyl is effective and safe to provide conscious sedation for cardiac catheterization laboratory procedures in adults.
Authors and Affiliations
Dr. Manoj Kamal, Dr. Geeta Singariya, Dr. Kamlesh Kumari, Dr. Monika Gupta, Dr. Bharat Paliwal, Dr. Pradeep Bhatia
Keywords
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