[Postoperative management of carotid endarterectomy with dexmedetomidine--a comparison with propofol]

Abstract

Background: We compared dexmedetomidine (DEX) with propofol (PRO) in patients requiring sedation after carotid endarterectomy (CEA) in the intensive care unit (ICU). Incidence of hyperperfusion syndrome, the sedative and analgesic properties, cardiovascular responses, and ventilation characteristics were discussed.

Methods: On arrival in the ICU, 66 patients were randomized to receive sedation with either DEX (0.2-0.7 microg x kg(-1) x hr(-1)) or PRO (1-3 mg x kg(-1) x hr(-1)) infusions. Additional analgesia was provided and patients were ventilated mechanically, if needed.

Results: No hyperperfusion syndrome occurred in either group. Eight patients in the DEX group required additional PRO infusions because of insufficiency for sedation. Patients receiving PRO infusions required significantly more analgesic agents and artificial ventilation than patients receiving DEX (P<0.05). Eleven patients in the PRO group required dopamine infusions because of hypotension.

Conclusions: DEX is a safe and acceptable sedative agent for patients requiring sedation after CEA in the ICU; however, further studies are needed to assess the appropriate sedative doses of DEX.