ABSTRACT
Objectives: To evaluate the sedative effect of dexmedetomidine (DEX) in patients with type I aortic dissection (AD) after total arch replacement surgery. Methods: A total of 237 AD patients with arch involvement received total arch replacement were enrolled; there were 199 (84.0%) male and the patient's mean age was (48.79±12.65) years. Based on post-operative application of sedatives during ICU stay, the patients were divided into 2 groups: DEX group, patients received load dose DEX 1μg/kg by slow intravenous injection, then (0.2-0.7) μg/(kg·h ) by continuous infusion, n=126 and Midazolam (MDZ) group, patients received load dose MDZ 0.05μg/kg by slow intravenous injection, then (0.02-0.1) mg/(kg·h ) by continuous infusion, n=111. Same surgical method was used in both groups, the mechanical ventilation time, incidence of delirium and other relevant indexes were compared between 2 groups. Results: Compared with MDZ group, DEX group had reduced mechanical ventilation time (3.97±1.28) d vs (4.99±1.58) d and ICU stay time (6.63±1.71) vs (7.24±2.56) d, less incidences of delirium (8.7% vs 18.9%) and permanent dysneuria (5.65% vs 13.5%), all P<0.05. Conclusions: Compared with MDZ, DEX may effectively reduce mechanical ventilation time, ICU stay time and the incidence of dysneuria in type I AD patients after total arch replacement surgery; it had positive role for patient's recovery.