DOES CONCOMITANT ADMINISTRATION OF DEXMEDETOMIDINE AND PROPOFOL PROVIDE MYOCARDIAL PROTECTION AND RENAL FUNCTION PRESERVATION IN COMPARISON TO PROPOFOL ALONE; A RANDOMIZED PROSPECTIVE STUDY

Abstract

Objective: To ascertain the safety and efficacy of concomitant administration of dexmedetomidine and propofol in maintaining myocardial protection and renal function integrity in comparison to propofol alone in adult cardiac surgical patients.

Methodology: A randomized clinical trial was conducted at cardiac center Bahawalpur from June 2018 to January 2020. Study included 64 patients who underwent coronary artery bypass grafting (CABG). Two groups, DP (DEXMEDETOMIDINE (DEX) +Propofol) and P (Propofol alone) were made by allocating 32 patients in each group. Hemodynamic parameters (Heart rate, Diastolic blood pressure (DBP), systolic blood pressure (SBP) and mean arterial pressure (MAP) at different time intervals throughout the surgery were measured, pre and post-operative CKMB, any arrhythmias, events of tachycardia and bradycardia were recorded and renal parameters (urine output immediate post pump and 4 hours post pump, creatinine clearance of day 1 and day 2) were measured.

Results: DP group showed stable hemodynamics with values of hemodynamic parameters were lesser and statistically significant than patients in group P (Heart rate (p<.05), DBP (P<.05), SBP (P<.05) and MAP (p<.05). Both groups showed insignificant difference in terms of incidence of arrhythmias (p=0.325), Post-operative CKMB (P=0.512), events of tachycardia (p=0.6) and bradycardia (p=0.5).Immediate post pump urine was statistically significant (p<.05), however, 4-hour post pump urine (p = 0.45), creatinine clearance of day 1 (p = 0.8) and day 2 (p =.092) were comparable.

Conclusion: Concomitant administration of dexmedetomidine and propofol provide adequate cardioprotection by maintaining stable hemodynamics in comparison to propofol alone, however they did not prove to be effective renoprotective agents.