Vasopressor Requirements Depends on Sedation Strategy

• Status: Completed
• Trial end date: 2022-05-29
• Target enrollment: 0
• Participant gender: All

Summary

Most of the patients after cardiac surgery need sedation in the iCU. Sedation strategy could impact the incidence of vasopressor use.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Anesthesia Research Group UA
• Treatments: Dexmedetomidine; Propofol

Criteria

Inclusion Criteria:

• Multi vascular lesions of the coronary arteries according to coronary angiography;

• Heart valve damage was confirmed by heart ultrasound, which is subject to surgical correction (aortic stenosis of III degree with a gradient on the aortic valve of more than 42 mmHg, aortic insufficiency III, mitral valve stenosis II-III, mitral regurgitation II-III)

• Age of patients from 18-80 years;

• Patient consent to participate in the study;

• Women who have a negative pregnancy test and use effective contraception throughout the study and for 3 weeks after its completion, or women who are unable to have children (women who have undergone a hysterectomy (removal of the uterus) or tubal ligation, women with a clinical diagnosis of infertility) or are menopausal for more than 1 year (absence of menstruation for at least 12 months). Adequate methods of contraception include: surgical sterilization, double barrier method of contraception, local contraception;

Exclusion Criteria:

• Refusal to participate;

• Hypersensitivity to propofol, dexmedetomidine;

• Prolonged mechanical ventilation in case of surgical complications (bleeding, inadequate perfusion of the myocardium);

• Occurred ischemic stroke;

• History of the ischemic stroke;

• History of the neurodegenerative diseases;

• History of the mental disorders;

• Use of neuroleptics, antidepressants for the last 5 years;

• History of the cardiac surgery in the past;

• Patients with chronic pulmonary disease (GOLD 3-4)

• Patients with asthma (moderate or severe),

• Participation in any other clinical trial;

• Gastric or duodenal ulcer with risk of bleeding;

• Chronic renal failure (ClCr less than 50 ml / h)

• Acute renal failure that occurred during surgery (ClCr less than 50 ml / h, or a decrease in the rate of diuresis to 0.1 ml / h in the first 4 hours after surgery and does not respond to diuretic therapy)

• Chronic hepatic insufficiency if there are laboratory signs of hypo coagulation without the use of anticoagulant therapy (INR> 1.5)

• If the patient has not stopped taking anticoagulants or antiplatelet agents in the preoperative period: warfarin 5 days before surgery, clopidogrel 5-7 days before surgery, xarelto / pradaxa 3 days before surgery),

• History of the hematological disease;

• Alcohol abuse in the anamnesis (3-4 times a week).

• Condition after chemotherapy;

• Pregnancy, lactation.