Effect of Dexmedetomidine with Adjuvants (Fentanyl and Butorphanol) on Postoperative Analgesia and Cognitive Dysfunction Following Cardiac Surgery: A Prospective, DoubleBlinded Randomized Controlled Trial
Bibliographic record
Abstract
Background: Painafter cardiac surgery has various sites of origin and is caused by several factors. Postoperative analgesia improves patient satisfaction, reduces the incidence of postoperative complications and shortens the duration of hospital stay. Objectives: To evaluate and compare the effect of intravenous infusion of dexmedetomidine and fentanyl versus intravenous infusion of dexmedetomidine and butorphanol on postoperative analgesia and postoperative cognitive dysfunction in patients undergoing cardiac surgery. Materials and Methods: This study was conducted at tertiary care teaching hospital of Rajasthan from February 2019 to June 2020. Patients in the two groups received intravenous infusion of Dexmedetomidine 0.15μg/kg/h and Fentanyl 0.5μg/kg/h immediately postoperatively (Group DF) and intravenous infusion of Dexmedetomidine 0.15μg/kg/h and Butorphanol 2 μg/kg/h immediately postoperatively (Group DB) respectively. Both groups were compared for demographic data, postoperative hemodynamic data, Ramsay sedation scale, visual analogue scale (VAS) for pain and Montreal Cognitive assessment (MoCA) for cognitive function. Results: There was no statistical difference in the VAS score of the patients between the group DB and DF at post extubation intervals of 12, 18, 24 and 48 Hours (p>0.05) except at 4 hours and 8 hours post extubation (p<0.05). Time to first rescue analgesic was significantly earlier for DF as compared to DB group (p<0.05). There was no statistical significant difference found in the mean of MoCA score between both the groups for both 1 day prior to surgery and 24hrs Post extubation (p>0.05). Drowsiness had the highest incidence in both the groups among all the adverse effects. There was no significant difference in terms of adverse effects (p>0.05) except drowsiness which was significantly higher in group DB (p<0.05). Conclusion: The present study concluded that Dexmedetomidine in combination with Butorphanol is more effective as an analgesic than Dexmedetomidine with Fentanyl but no significant cognitive dysfunction was found among the patients in both groups.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".