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Randomized Controlled Trial
. 2016 Oct-Dec;19(4):606-613.
doi: 10.4103/0971-9784.191570.

The myocardial protective effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery

Rabie Soliman  1 , Gomaa Zohry  1
Affiliations
Randomized Controlled Trial

The myocardial protective effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery

Rabie Soliman et al. Ann Card Anaesth. 2016 Oct-Dec.

Abstract

Objective: The aim of the study was to assess the effect of dexmedetomidine in high-risk patients undergoing aortic vascular surgery.

Design: A randomized prospective study.

Setting: Cairo University, Egypt.

Materials and methods: The study included 150 patients undergoing aortic vascular surgery.

Intervention: The patients were classified into two groups (n = 75). Group D: The patients received a loading dose of 1 μg/kg dexmedetomidine over 15 min before induction and maintained as an infusion of 0.3 μg/kg/h to the end of the procedure. Group C: The patients received an equal volume of normal saline. The medication was prepared by the nursing staff and given to anesthetist blindly.

Measurements: The monitors included the heart rate, mean arterial blood pressure, central venous pressure, electrocardiogram (ECG), serum troponin I level, end-tidal sevoflurane, and total dose of morphine in addition transthoracic echocardiography to the postoperative in cases with elevated serum troponin I level.

Main results: The dexmedetomidine decreased heart rate and minimized the changes in blood pressure compared to control group (P < 0.05). Furthermore, it decreased the incidence of myocardial ischemia reflected by troponin I level, ECG changes, and the development of new regional wall motion abnormalities (P < 0.05). Dexmedetomidine decreased the requirement for nitroglycerin and norepinephrine compared to control group (P < 0.05). The incidence of hypotension and bradycardia was significantly higher with dexmedetomidine (P < 0.05).

Conclusion: The dexmedetomidine is safe and effective in patients undergoing aortic vascular surgery. It decreases the changes in heart rate and blood pressure during the procedures. It provides cardiac protection in high-risk patients reflected by decreasing the incidence of myocardial ischemia and serum level of troponin. The main side effects of dexmedetomidine were hypotension and bradycardia.

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References

    1. Robe J, Carell TP, Neidhart P. Anaesthetic management of patients undergoing surgery on the descending aorta. Baillieres Clin Anaesthesiol. 2000;14:173–86.
    1. Attia RR, Murphy JD, Snider M, Lappas DG, Darling RC, Lowenstein E. Myocardial ischemia due to infrarenal aortic cross-clamping during aortic surgery in patients with severe coronary artery disease. Circulation. 1976;S3:961–5. - PubMed
    1. Gilling-Smith GL, Worswick L, Knight PF, Wolfe JH, Mansfield AO. Surgical repair of thoracoabdominal aortic aneurysm: 10 years’ experience. Br J Surg. 1995;82:624–9. - PubMed
    1. Cox GS, O’Hara PJ, Hertzer NR, Piedmonte MR, Krajewski LP, Beven EG. Thoracoabdominal aneurysm repair: A representative experience. J Vasc Surg. 1992;15:780–7. - PubMed
    1. Svensson LG, Crawford ES, Hess KR, Coselli JS, Safi HJ. Experience with 1509 patients undergoing thoracoabdominal aortic operations. J Vasc Surg. 1993;17:357–68. - PubMed

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