Volume 1, Issue 4 (2022)                   GMJM 2022, 1(4): 109-114 | Back to browse issues page
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Sharifi S, Saberi K, Rahmanian M, Bakhshandeh A. Effect of Perioperative Administration of Dexmedetomidine in Cardiac Surgeries. GMJM 2022; 1 (4) :109-114
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1- National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Imam Khomeini Medical and Research Centre, Tehran University of Medical Sciences, Tehran, Iran
* Corresponding Author Address: Imam Khomeini Medical and Research Centre, Tehran University of Medical Sciences, Tehran, Iran (saberikn@yahoo.com)
Abstract   (239 Views)
Aims: Despite many developments in the health care of cardiac surgery patients, yet 5%–30% of them may become challenged due to renal dysfunction, delirium, and arrhythmia. Eliminating or reducing these unwanted outcomes is likely to improve the prognosis of them. The purpose of the current study was to investigate the outcome of the administration of DEX in patients undergoing cardiac surgeries.
Materials & Methods: The data from patents who underwent coronary artery bypass grafting (CABG) without a valve, CABG with valve surgery, and valve-only surgery from August to November 2018 were analyzed. A total of 51 patients were eligible for our study after extraction. For the DEX group, the infusion of DEX was started 10 min before anesthesia induction in a 0.2–0.6 µg/Kg/h rate. And the same amount of normal saline (0.9%) was infused for the control group. The infusion was continued post-operatively until extubation (maximum for 24h). The patients were compared primarily for Acute Kidney Injury (AKI), delirium, new-onset atrial fibrillation (AF) rhythm.
Findings: There was no significant difference between groups for demographic data. One patient (16.7%) from the DEX group and five patients (83.3%) from the control group revealed an AF rhythm after surgery (p=0.009). No patient faced delirium. Seven patients seemed to be AKI, of which five (71.4%) were in the DEX group and two (28.6%) were in the control group (p>0.05).
Conclusion: There might be a meaningful reduction of new-onset AF rhythm in adult patients who use DEX after cardiac surgeries.
 
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References
1. Song Y, Kim DH, Kwon TD, Han DW, Baik SH, Jung HH, et al. Effect of intraoperative dexmedetomidine on renal function after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: A randomized, placebo-controlled trial. Int J Hyperthermia. 2019;36(1):1-8. [Link] [DOI:10.1080/02656736.2018.1526416]
2. Cheng H, Li Z, Young N, Boyd D, Atkins Z, Ji F, et al. The effect of dexmedetomidine on outcomes of cardiac surgery in elderly patients. J Cardiothorac Vasc Anesth. 2016;30(6):1502-8. [Link] [DOI:10.1053/j.jvca.2016.02.026]
3. Liu X, Xie G, Zhang K, Song S, Song F, Jin Y, et al. Dexmedetomidine vs propofol sedation reduces delirium in patients after cardiac surgery: A meta-analysis with trial sequential analysis of randomized controlled trials. J Crit Care. 2017;38:190-6. [Link] [DOI:10.1016/j.jcrc.2016.10.026]
4. Pavone KJ, Cacchione PZ, Polomano RC, Winner L, Compton P. Evaluating the use of dexmedetomidine for the reduction of delirium: An integrative review. Heart Lung. 2018;47(6):591-601. [Link] [DOI:10.1016/j.hrtlng.2018.08.007]
5. Wang G, Niu J, Li Z, Lv H, Cai H. The efficacy and safety of dexmedetomidine in cardiac surgery patients: A systematic review and meta-analysis. PLoS One. 2018;13(9):e0202620. [Link] [DOI:10.1371/journal.pone.0202620]
6. Ji F, Li Z, Nguyen H, Young N, Shi P, Fleming N, et al. Perioperative dexmedetomidine improves outcomes of cardiac surgery. Circulation. 2013;127(15):1576-84. [Link] [DOI:10.1161/CIRCULATIONAHA.112.000936]
7. Chen Y, Feng X, Hu X, Sha J, Li B, Zhang H, et al. Dexmedetomidine ameliorates acute stress-induced kidney injury by attenuating oxidative stress and apoptosis through inhibition of the ROS/JNK signaling pathway. Oxid Med Cell Longev. 2018;2018:4035310. [Link] [DOI:10.1155/2018/4035310]
8. Zientara A, Mariotti S, Matter-Ensner S, Seifert B, Graves K, Dzemali O, et al. Fast-track management in off-pump coronary artery bypass grafting: Dexmedetomidine provides rapid extubation and effective pain modulation. Thorac Cardiovasc Surg. 2019;67(6):450-7. [Link] [DOI:10.1055/s-0038-1668602]
9. Erratum: Comparison of the renoprotective effect of dexmedetomidine and dopamine in high-risk renal patients undergoing cardiac surgery: A double-blind randomized study. Ann Card Anaesth. 2018;21(1):108. [Link]
10. Rawat RS, Al Maashani SM. Perioperative renal protection during cardiac surgery: A choice between dopamine and dexmedetomidine. Ann Card Anaesth. 2018;21(1):4-5. [Link]
11. Ammar AS, Mahmoud KM, Kasemy ZA, Helwa MA. Cardiac and renal protective effects of dexmedetomidine in cardiac surgeries: A randomized controlled trial. Saudi J Anaesth. 2016;10(4):395-401. [Link] [DOI:10.4103/1658-354X.177340]
12. Liu Y, Sheng B, Wang S, Lu F, Zhen J, Chen W. Dexmedetomidine prevents acute kidney injury after adult cardiac surgery: A meta-analysis of randomized controlled trials. BMC Anesthesiol. 2018;18(1):7. [Link] [DOI:10.1186/s12871-018-0472-1]
13. Chang YF, Chao AN, Shih PY, Hsu YC, Lee CT, Tien YW, et al. Comparison of dexmedetomidine versus propofol on hemodynamics in surgical critically ill patients. J Surg Res. 2018;228:194-200. [Link] [DOI:10.1016/j.jss.2018.03.040]
14. Ren J, Zhang H, Huang L, Liu Y, Liu F, Dong Z. Protective effect of dexmedetomidine in coronary artery bypass grafting surgery. Exp Ther Med. 2013;6(2):497-502. [Link] [DOI:10.3892/etm.2013.1183]
15. Zhao ZY, Gan JH, Liu JB, Cheng Q. Clinical evaluation of combination of dexmedetomidine and midazolam vs. dexmedetomidine alone for sedation during spinal anesthesia. Saudi J Biol Sci. 2017;24(8):1758-62. [Link] [DOI:10.1016/j.sjbs.2017.11.007]
16. Watt S, Sabouri S, Hegazy R, Gupta P, Heard C. Does dexmedetomidine cause less airway collapse than propofol when used for deep sedation? J Clin Anesth. 2016;35:259-67. [Link] [DOI:10.1016/j.jclinane.2016.07.035]
17. Wang XQ, Liu NF, Chen JL, Xu Z, Wang FM, Ding C. Effect of intravenous dexmedetomidine during general anesthesia on acute postoperative pain in adults: A systematic review and meta-analysis of randomized controlled trials. Clin J Pain. 2018;34(12):1180-91. [Link] [DOI:10.1097/AJP.0000000000000630]
18. Pasero D, Sangalli F, Baiocchi M, Blangetti I, Cattaneo S, Paternoster G, et al. Experienced use of dexmedetomidine in the intensive care unit: A report of a structured consensus. Turk J Anaesthesiol Reanim. 2018;46(3):176-83. [Link] [DOI:10.5152/TJAR.2018.08058]
19. Ling X, Zhou H, Ni Y, Wu C, Zhang C, Zhu Z. Does dexmedetomidine have an antiarrhythmic effect on cardiac patients? A meta-analysis of randomized controlled trials. PLoS One. 2018;13(3):e0193303. [Link] [DOI:10.1371/journal.pone.0193303]
20. Zhu ZP, Zhou HM, Ni YJ, Wu C, Zhang CJ, Ling XY. Can dexmedetomidine reduce atrial fibrillation after cardiac surgery? A systematic review and meta-analysis. Drug Des Dev Ther. 2018;12:521-31. [Link] [DOI:10.2147/DDDT.S153834]
21. Flukiger J, Hollinger A, Speich B, Meier V, Tontsch J, Zehnder T, et al. Dexmedetomidine in prevention and treatment of postoperative and intensive care unit delirium: A systematic review and meta-analysis. Ann Intensive Care. 2018;8(1):92. [Link] [DOI:10.1186/s13613-018-0437-z]
22. Guldenmund P, Vanhaudenhuyse A, Sanders RD, Sleigh J, Bruno MA, Demertzi A, et al. Brain functional connectivity differentiates dexmedetomidine from propofol and natural sleep Br J Anaesth. 2017;119(4):674-84. [Link] [DOI:10.1093/bja/aex257]
23. Lam RPK, Yip WL, Wan CK, Tsui MSH. Dexmedetomidine use in the ED for control of methamphetamine-induced agitation. Am J Emerg Med. 2017;35(4):665.e1-e4. [Link] [DOI:10.1016/j.ajem.2016.11.004]
24. Habibi V, Kiabi FH, Sharifi H. The effect of dexmedetomidine on the acute pain after cardiothoracic surgeries: A systematic review. Braz J Cardiovasc Surg. 2018;33(4):404-17. [Link] [DOI:10.21470/1678-9741-2017-0253]
25. Gallego-Ligorit L, Vives M, Valles-Torres J, Sanjuan-Villarreal TA, Pajares A, Iglesias M. Use of dexmedetomidine in cardiothoracic and vascular anesthesia. J Cardiothor Vasc An. 2018;32(3):1426-38. [Link] [DOI:10.1053/j.jvca.2017.11.044]