The effect of controlled sedation based on the Richmond scale on the duration of mechanical ventilation and the changes of blood pressure in patients following coronary artery bypass graft surgery: A randomized clinical trial

• Main Authors: Mohammad Reza Yeganeh, Somayeh Gholami, Rasoul Tabari, Zahra Atrkar Roshan, Siamak Rimaz, Moluk pouralizadeh
• Format: Article
• Language: fas
• Published: Tehran University of Medical Sciences 2018-01-01
• Series: حیات
• Subjects: sedative; coronary artery bypass surgery; blood pressure; agitation
• Online Access: http://hayat.tums.ac.ir/article-1-1937-en.html

Background & Aim: Sedation after coronary artery bypass graft surgery can prevent the side effects of the treatment. The purpose of this study was to determine the effect of controlled sedation based on the Richmond scale on the duration of mechanical ventilation and the changes of blood pressure in patients following coronary artery bypass graft surgery. Methods & Materials: In a single blind randomized clinical trial (IRCT2017050517693N2) from June to August 2017, a convenience sample of 80 patients after coronary artery bypass graft surgery, hospitalized in the intensive care unit of Heshamat Center, Rasht, were selected and randomly allocated into two groups (each group=40). Sedative drug dose was determined using the Richmond agitation sedation scale in the intervention group and determined routinely (based on hemodynamic changes) in the control group. Pain as a confounding variable was evaluated using CPOT tool. Data were analyzed by descriptive statistics and Chi-square, Mann-Whitney, independent t-test and repeated measures ANOVA using the SPSS software version 22. Results: The mean age of samples was 59.89±7.53 and 66.7% of them were male. There was a significant difference between two groups in the duration of mechanical ventilation (P<0.04), the changes of patients’ blood pressure (P<0.05), need for a vasopressor drug (P<0.05) until extubation and need for the first administration of sedatives (P<0.001). Conclusion: Utilizing the Richmond tool can reduce the patient’s dependence on ventilator and changes in arterial pressure. Also, using this tool can prevent unnecessary and early administration of sedative and vasopressor drugs in patients.