Evaluation of the use of the Richmond tool in opioid need and its effects on the hemodynamic status of patients admitted to intensive care unit after coronary artery bypass grafting

Abstract

Due to the fact that Richmond sedation maintenance protocol is not used in Iran and uncontrolled mechanical ventilation can cause dangerous complications after coronary artery bypass graft surgery and also the positive effects of this intervention in controlling sedation in patients after coronary artery graft. To conduct the present study with the aim of investigating the use of Richmond score in opioid need and its effects on the hemodynamic status of patients admitted to the intensive care unit after coronary artery graft; The purpose of using this score is to reach an acceptable range, ie scores above two, so that there are no obvious changes in hemodynamic status for patients after surgery; Because severe hemodynamic changes can affect postoperative outcomes, the use of this tool may lead to beneficial effects by controlling and minimizing hemodynamic changes. Materials and Methods: In this randomized, single-blind clinical trial study, 86 patients after coronary artery bypass graft surgery were randomly divided into two groups. The amount of sedation in the intervention group was based on the Richmond protocol and in the control group was performed according to the routine section. Duration of ventilation, need for opioid medication and hemodynamic status between the two groups were compared between the two groups using descriptive and inferential statistical tests with a p value of less than 0.05. Results: The results showed that the mean arterial pressure at all times between the two groups was statistically significant and also the mean total blood pressure was different between the two groups (P = 0.003). Studies on the duration of ventilation showed that the mean duration of ventilation in the intervention group was significantly lower than the control group (P = 0.001); Also, the need for opioid drug in the control group was significantly higher than the intervention group (P = 0.003).