Comparison of dexmedetomidine versus midazolam sedation for myocardial protection in patients undergoing percutaneous coronary intervention
10:3760/cma.j.issn.0254-1416.2014.08.006
- VernacularTitle:右美托咪定与咪达唑仑镇静对经皮冠状动脉介入治疗患者心肌保护效应的比较
- Author:
Shuang ZHOU
;
Fuhai JI
- Publication Type:Journal Article
- Keywords:
Dexmedetomidine;
Midazolam;
Coronary artery;
Stent;
Myocardial reperfusion injury;
Myocardial Infarction;
Conscious sedation
- From:
Chinese Journal of Anesthesiology
2014;34(8):933-936
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare dexmedetomidine versus midazolam sedation for myocardial protection in the patients undergoing percutaneous coronary intervention (PCI).Methods Sixty patients with acute myocardial infarction who required for emergency PCI,were selected and randomly divided into 2 groups (n =30 each) using a random number table:dexmedetomidine group (group D) and midazolam group (group M).In group D,a loading dose of dexmedetomidine 1 μg/kg was infused intravenously for 10 min before surgery.In group M,midazolam 0.05 mg/kg was injected intravenously before surgery.Dexmedetomidine 0.2-1.4 μg· kg-1 · h-1 and midazolam 0.02-0.10 mg·kg-1 ·h-1 were given via a pump during surgery until the end of surgery in the two groups.The RASS score was maintained at-2-2 in two groups.Before administration and on 3rd day after surgery,cardiovascular color doppler ultrasound was performed to record left ventricular ejection fraction (LVEF),venous blood samples were collected for determination of the levels of serum myocardial enzyme and cardiac troponin I (cTnI),and the development of surgical complications,duration of ICU stay and length of hospital stay were recorded.Results Compared with group M,the activities of serum creatine kinase,creatine kinase isoenzyme-MB,aspartate amino transferase and lactic dehydrogenase and cTnI concentrations were significantly decreased,LVEF was increased,and duration of ICU stay and length of hospital stay were shortened in group D.There was no significant difference in the development of postoperative complications between the two groups.Conclusion Dexmedetomidine sedation provides better efficacy for myocardial protection and prognosis and is more suitable for sedation than midazolam in the patients undergoing PCI.
