Retrospective analysis of dexmedetomidine and morphine in the fast-track and ultra fast-track extubation protocol after congenital cardiac surgery


Altun D. , Arnaz A. , Doğan A., Yalçınbaş Y., Türköz R., Oktay A., ...More

17th World Congress of Anaesthesiologists, 1 - 05 September 2021, vol.133, no.3, pp.283

  • Publication Type: Conference Paper / Summary Text
  • Volume: 133
  • Page Numbers: pp.283

Abstract

Background and aim of the study: After congenital cardiac surgery, the duration of mechanical ventilation

is related to the clinical status, type of operation, and the sedative-analgesic agents used

postoperatively. This study aimed to examine the effects of dexmedetomidine and morphine on the

fast-track and ultra fast-track extubation protocol after congenital cardiac surgery.

Methods: Two hundred fifty-one pediatric patients were divided into two groups: 118 patients in the

morphine group (Group M), 133 patients in the dexmedetomidine group (Group D). We retrospectively

reviewed medical data including hemodynamic parameters, duration of mechanical ventilation

(MV) and cardiovascular intensive care unit (CICU), additional sedative/analgesic requirement, adverse

events, the need for reintubation, and noninvasive MV, sedation, and pain scores.

Results: Mechanical ventilation duration of Group D was significantly shorter than Group M (3.74 ±

0.83 (median = 4) hour in Group D; 5.72 ± 1.54 (median = 5.5) hour in Group M, respectively) (p =

0.001; p < 0.05). In group D the success rate of FT extubation was 92.5% (n =123) and UFT extubation

was 7.5% (n = 10) (p = 0.001). In group M the success rate of FT extubation was 72.9% (n = 86) and

UFT extubation was 0% (n = 0) (p>0.05).

Conclusions: Dexmedetomidine and morphine have clinical benefits that encourage their use for

fast-track extubation protocol. Dexmedetomidine has more benefits compared to morphine. It can

be used in ultra fast-track extubation protocol besides its use in fast-track extubation protocol with

fewer side effects.