The primary health problem studied in this research is acute postoperative pain following elective cardiac surgery via median sternotomy. The study investigates the potential of dexmedetomidine infusion to improve pain management and reduce opioid consumption in this patient population Okay, here are the keywords from the research proposal, one per line: Dexmedetomidine Postoperative Pain Cardiac Surgery Median Sternotomy Opioid Consumption Pain Management
Conditions
Interventions
Dexmedetomidine infusion will be initiated at a rate of 0.5 micrograms per kilogram of actual body weight per hour for 12 hours in the intervention group.,In the placebo group, patients will receive a
Experimental Drug,Placebo Comparator No treatment
Sponsors
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Eligibility
Sex/Gender
All
Age
20 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Patients who admitted at Maharaj Nakorn Chiang Mai Hospital with aged between 20 and 80 years old 2. Scheduled for elective cardiac surgery via median sternotomy (with or without cardiopulmonary bypass), including CABG or OPCAB, and combined CABG and valve surgery.
Exclusion criteria
Exclusion criteria: 1. Patients who known as hypersensitivity or allergy to dexmedetomidine 2. Patients with chronic opioid use or opioid dependent 3. Underlying renal impairment (Crcl < 30) 4. Underlying Hepatic impairment (AST or ALT > 2 times) 5. Pacemaker or intracardiac devices before surgery 6. Bradycardia or arrhythmia 7. Patients with LVEF equal or lower than 40% 8. Pregnancy or Breastfeeding 9. Psychiatric patient 10.BMI > 30 kg/m2 11.Parasternal block 12.Previous cardiac surgery via median sternotomy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| pain score postoperatively after arrival at ICU 0,2,4,6,8,10 and 12 hours postoperatively standard 10-cm visual analog scale (VAS),Opioid consumption until discharge from ICU Measured as the total cumulative dose of intravenous fentanyl (in micrograms) used from ICU admission until ICU discharge. | — |
Secondary
| Measure | Time frame |
|---|---|
| Time to extubation after ICU admission Recorded in hours from ICU admission to successful removal of the endotracheal tube,Sedation score assessed at 0,2,4,6, 8,10 and 12 hours postoperatively Assessed using the Richmond Agitation-Sedation Scale (RASS),Length of ICU and hospital stay until patient discharge Measured in days, obtained from electronic medical records.,Adverse events after ICU admission Monitored and documented by clinical staff using predefined clinical criteria.,In-hospital mortality after ICU admission Monitored and documented by clinical staff using predefined clinical criteria. | — |
Countries
Thailand
Contacts
Public ContactNatsuda Phothikun
Faculty of Medicine, Chiang Mai University, Chiang Mai
Outcome results
None listed