EFFECT OF PERIOPERATIVE DEXMEDETOMIDINE ON CARDIAC SURGERY OUTCOME

Authors

  • H ZAFAR Department Of Cardiac Surgery, Faisalabad Institute Of Cardiology Faisalabad, Pakistan
  • T ASHRAF Department Of Cardiac Surgery, Punjab Institute Of Cardiology Lahore, Pakistan
  • N AHMED Department Of Cardiac Surgery, Faisalabad Institute Of Cardiology Faisalabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2022i1.171

Keywords:

Dexmedetomidine, cardiac surgery, α-2 agonists, myocardial infarction

Abstract

This retrospective study was designed to assess the impact of perioperative dexmedetomidine on the outcome of open-heart surgery. This study was conducted at the Faisalabad Institute of Cardiology Faisalabad from 01 Jan 2022 to Dec 2022. A total of 350 fulfilled the inclusion criteria and were included in the study. Informed consent of the participants was taken. The ethical board of the hospital approved the study. Subjects were divided into the dexmedetomidine group (who were administered dexmedetomidine peri operatively, 179 (51%)) and non-dexmedetomidine group (who were not helped dexmedetomidine peri operatively, 171(48.8%).0.24-0.6 μg/kg/h was infused intravenously after cardiopulmonary bypass. The was continued for more than twenty-four hours postoperatively.10 out of 350 subjects (2.8%) died in hospital, and 14 (4%) died within thirty days. Perioperative dexmedetomidine infusion resulted in a significant reduction in hospital and 30-day mortality. In-hospital mortality in the dexmedetomidine and non-dexmedetomidine group were 1.22% and 4.6%, respectively (P=.008). 30-day mortality in the dexmedetomidine and non-dexmedetomidine groups was 1.8% and 5.2%,  respectively (P=.002). Perioperative dexmedetomidine significantly reduced post-operative sepsis (0.8% vs. 2.2%, P=.043) and other complications (46.19% vs. 56.07%, P=.0205). There was no difference in the duration of hospital stay, ICU stay, post-operative ventilation time, and incidence of delirium and MACEs. So, it can be concluded that perioperative intravenous dexmedetomidine results in improved hospital and thirty-day survival and is associated with a decrease in post-operative delirium and overall complications.

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References

Aboul-Hassan, S. S., Stankowski, T., Marczak, J., Peksa, M., Nawotka, M., Stanislawski, R., and Cichon, R. (2020). Timing strategy of preoperative aspirin and its impact on early outcomes in patients undergoing coronary artery bypass grafting: a propensity score matching analysis. Journal of Surgical Research 246, 251-259.

Arnold, R. W., Biggs, R. E., and Beerle, B. J. (2018). Intravenous dexmedetomidine augments the oculocardiac reflex. Journal of American Association for Pediatric Ophthalmology and Strabismus 22, 211-213. e1.

Bangalore, S., Barsness, G. W., Dangas, G. D., Kern, M. J., Rao, S. V., Shore-Lesserson, L., and Tamis-Holland, J. E. (2021). Evidence-based practices in the cardiac catheterization laboratory: a scientific statement from the American Heart Association. Circulation 144, e107-e119.

Basavaraddi, S. (2022). Comparision of melatonin and clonidine as oral premedicants in adult patients undergoing elective surgeries under general anaesthesia: adouble-blind randomised prospective study, Shri Dharmasthala Manjunatheshwara University, Dharwad.

Carnicelli, P., Otsuki, D. A., Monteiro Filho, A., Kahvegian, M. A. P., Ida, K. K., Auler-Jr, J. O. C., Rouby, J.-J., and Fantoni, D. T. (2022). Effects of dexmedetomidine on hemodynamic, oxygenation, microcirculation, and inflammatory markers in a porcine model of sepsis. Acta Cirúrgica Brasileira 37.

Duncan, D., Sankar, A., Beattie, W. S., and Wijeysundera, D. N. (2018). Alpha‐2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery. Cochrane Database of Systematic Reviews.

Gideon, A., Sauter, C., Pruessner, J. C., Farine, D. R., and Wirtz, P. H. (2022). Determinants and mechanisms of the renin-aldosterone stress response. Psychosomatic medicine 84, 50-63.

He, L., Hao, S., Wang, Y., Yang, W., Liu, L., Chen, H., and Qian, J. (2019). Dexmedetomidine preconditioning attenuates ischemia/reperfusion injury in isolated rat hearts with endothelial dysfunction. Biomedicine & Pharmacotherapy 114, 108837.

Kartal, S., Kip, G., Küçük, A., Aşçı, S. S., Erdem, Ö., Arslan, M., and Kavutçu, M. (2020). The effects of dexmedetomidine and ketamine on oxidative injuries and histological changes following blunt chest trauma. Drug Design, Development and Therapy 14, 2937.

Koutsaki, M., Patoulias, D., Tsinivizov, P., Doumas, M., Kallistratos, M., Thomopoulos, C., Poulimenos, L., Agnelli, G., Mancia, G., and Manolis, A. (2019). Evaluation, risk stratification and management of hypertensive patients in the perioperative period. European Journal of Internal Medicine 69, 1-7.

Kurlansky, P. A., O’Brien, S. M., Vassileva, C. M., Lobdell, K. W., Edwards, F. H., Jacobs, J. P., von Ballmoos, M. W., Paone, G., Edgerton, J. R., and Thourani, V. H. (2022). Failure to rescue: a new Society of Thoracic Surgeons quality metric for cardiac surgery. The Annals of thoracic surgery 113, 1935-1942.

Lee, S. (2019). Dexmedetomidine: present and future directions. Korean journal of anesthesiology 72, 323-330.

Ma, J., Chen, Q., Li, J., Zhao, H., Mi, E., Chen, Y., Yi, B., Ning, J., Ma, D., and Lu, K. (2020). Dexmedetomidine-mediated prevention of renal ischemia-reperfusion injury depends in part on cholinergic anti-inflammatory mechanisms. Anesthesia & Analgesia 130, 1054-1062.

Nicola, H., and Ho, K. M. (2019). Aspirin resistance incidence and associations between aspirin effect and outcomes in cardiac surgery. The Annals of Thoracic Surgery 108, 1815-1821.

Novotny, S., Dokko, J., Zhang, X., Agha, S., Yaligar, A., Kolba, N., Tummala, V., Parikh, P. B., Pryor, A. D., and Tannous, H. J. (2022). Preoperative atrial fibrillation/flutter impact on risk-adjusted repeat aortic intervention patients. Vessel Plus 6, 51.

Roth, S., Torregroza, C., Feige, K., Preckel, B., Hollmann, M. W., Weber, N. C., and Huhn, R. (2021). Pharmacological conditioning of the heart: An update on experimental developments and clinical implications. International Journal of Molecular Sciences 22, 2519.

Schubert, S. A., Hawkins, R. B., Mehaffey, J. H., Fonner, C. E., Rich, J. B., Speir, A. M., Quader, M., Kron, I. L., Yarboro, L. T., and Ailawadi, G. (2019). Preoperative β-blocker use correlates with worse outcomes in patients undergoing aortic valve replacement. The Journal of thoracic and cardiovascular surgery 158, 1589-1597. e3.

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Published

2022-12-25

How to Cite

ZAFAR, H., ASHRAF, T., & AHMED, N. (2022). EFFECT OF PERIOPERATIVE DEXMEDETOMIDINE ON CARDIAC SURGERY OUTCOME. Biological and Clinical Sciences Research Journal, 2022(1). https://doi.org/10.54112/bcsrj.v2022i1.171

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Original Research Articles

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