Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial
Background: Arrhythmia occurring during and after surgery is one of the major complications in open-heart surgery. Dexmedetomidine is an intravenous alpha-2 agonist and very specific short-acting drug to protect the various organs against ischemic injuries and blood reflow. However, the effect of...
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| Format: | Article |
| Language: | English |
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Electronic Physician
2017-10-01
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| Series: | Electronic Physician |
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718864/ |
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| author | Ghasem Soltani Saeed Jahanbakhsh Mohammad Abbasi Tashnizi Mehdi Fathi, Shahram Amini, Nahid Zirak Shima Sheybani |
| author_facet | Ghasem Soltani Saeed Jahanbakhsh Mohammad Abbasi Tashnizi Mehdi Fathi, Shahram Amini, Nahid Zirak Shima Sheybani |
| author_sort | Ghasem Soltani |
| collection | DOAJ |
| description | Background: Arrhythmia occurring during and after surgery is one of the major complications in open-heart
surgery. Dexmedetomidine is an intravenous alpha-2 agonist and very specific short-acting drug to protect the
various organs against ischemic injuries and blood reflow. However, the effect of dexmedetomidine for
preventing intraoperative heart arrhythmias has not been recognized.
Objective: This study aimed to determine the effect of dexmedetomidine on the incidence rate of heart
arrhythmias and anesthetic required in off-pump coronary artery bypass surgery.
Methods: This randomized clinical trial was conducted on patients who were candidates for off-pump coronary
artery bypass referring to Imam Reza Hospital of Mashhad, Iran, from July 2016 through January 2017. The
patients were randomly assigned to two groups of intervention (infusion of 0.5 mcg/kg/h dexmedetomidine
together with induction followed by infusion of 0.5 mcg/kg/h by the end of the surgery) or control (saline
infusion). Mean arterial pressure (MAP) and heart rate (HR) were measured before induction, during surgery
operation and ICU admission. Data were analyzed by SPSS version 18 using Chi Square and independent- samples t-test.
Results: A total of 76 patients with a mean age of 59.8 ± 8.2 years (in two groups of 38) were studied. The two
groups had no statistically significant difference in terms of background variables. The MAP and HR values
before induction, during surgery and ICU admission were significantly higher in the control group than in the
intervention group (p=0.001). Out of the studied arrhythmias, the values of PAC (55.2% vs. 15.7%), PVC (81.5%
vs. 21.0%), AF (26.3% vs. 7.8%), VTAC (21.0% vs. 2.6%) were significantly lower in dexmedetomidine group
(p=0.001).
Conclusion: It seems that dexmedetomidine administration during induction and surgery can cause significant
reduction in most of the common arrhythmias in off-pump coronary bypass surgery. The use of dexmedetomidine
maintains MAP and HR at significantly lower values, and changes compared to the control group as well as
reduces the need for anesthetic compounds.
Trial Registration: The present study has been registered at the Iranian Registry of Clinical Trials
(www.IRCT.IR) with a code of IRCT2016072413159N9 before starting the study.
Founding: This study was fully sponsored by the Research Deputy at Mashhad University of Medical Sciences,
Iran (grant number 941413). |
| first_indexed | 2024-12-22T15:52:54Z |
| format | Article |
| id | doaj.art-3f1b3829601d47a294cd856f4453b8be |
| institution | Directory Open Access Journal |
| issn | 2008-5842 2008-5842 |
| language | English |
| last_indexed | 2024-12-22T15:52:54Z |
| publishDate | 2017-10-01 |
| publisher | Electronic Physician |
| record_format | Article |
| series | Electronic Physician |
| spelling | doaj.art-3f1b3829601d47a294cd856f4453b8be2022-12-21T18:20:52ZengElectronic PhysicianElectronic Physician2008-58422008-58422017-10-019105578558710.19082/5578Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trialGhasem SoltaniSaeed JahanbakhshMohammad Abbasi TashniziMehdi Fathi,Shahram Amini,Nahid ZirakShima SheybaniBackground: Arrhythmia occurring during and after surgery is one of the major complications in open-heart surgery. Dexmedetomidine is an intravenous alpha-2 agonist and very specific short-acting drug to protect the various organs against ischemic injuries and blood reflow. However, the effect of dexmedetomidine for preventing intraoperative heart arrhythmias has not been recognized. Objective: This study aimed to determine the effect of dexmedetomidine on the incidence rate of heart arrhythmias and anesthetic required in off-pump coronary artery bypass surgery. Methods: This randomized clinical trial was conducted on patients who were candidates for off-pump coronary artery bypass referring to Imam Reza Hospital of Mashhad, Iran, from July 2016 through January 2017. The patients were randomly assigned to two groups of intervention (infusion of 0.5 mcg/kg/h dexmedetomidine together with induction followed by infusion of 0.5 mcg/kg/h by the end of the surgery) or control (saline infusion). Mean arterial pressure (MAP) and heart rate (HR) were measured before induction, during surgery operation and ICU admission. Data were analyzed by SPSS version 18 using Chi Square and independent- samples t-test. Results: A total of 76 patients with a mean age of 59.8 ± 8.2 years (in two groups of 38) were studied. The two groups had no statistically significant difference in terms of background variables. The MAP and HR values before induction, during surgery and ICU admission were significantly higher in the control group than in the intervention group (p=0.001). Out of the studied arrhythmias, the values of PAC (55.2% vs. 15.7%), PVC (81.5% vs. 21.0%), AF (26.3% vs. 7.8%), VTAC (21.0% vs. 2.6%) were significantly lower in dexmedetomidine group (p=0.001). Conclusion: It seems that dexmedetomidine administration during induction and surgery can cause significant reduction in most of the common arrhythmias in off-pump coronary bypass surgery. The use of dexmedetomidine maintains MAP and HR at significantly lower values, and changes compared to the control group as well as reduces the need for anesthetic compounds. Trial Registration: The present study has been registered at the Iranian Registry of Clinical Trials (www.IRCT.IR) with a code of IRCT2016072413159N9 before starting the study. Founding: This study was fully sponsored by the Research Deputy at Mashhad University of Medical Sciences, Iran (grant number 941413).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718864/Coronary BypassDexmedetomidineMean Arterial PressureHeart rate |
| spellingShingle | Ghasem Soltani Saeed Jahanbakhsh Mohammad Abbasi Tashnizi Mehdi Fathi, Shahram Amini, Nahid Zirak Shima Sheybani Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial Electronic Physician Coronary Bypass Dexmedetomidine Mean Arterial Pressure Heart rate |
| title | Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial |
| title_full | Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial |
| title_fullStr | Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial |
| title_full_unstemmed | Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial |
| title_short | Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial |
| title_sort | effects of dexmedetomidine on heart arrhythmia prevention in off pump coronary artery bypass surgery a randomized clinical trial |
| topic | Coronary Bypass Dexmedetomidine Mean Arterial Pressure Heart rate |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718864/ |
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