Evaluation of the safety and efficacy of dexmedetomidine as an anesthetic adjuvant in coronary artery bypass grafting surgeries

Abstract

Background: Coronary artery bypass grafting (CABG) is a key treatment for coronary artery disease, yet it carries a significant risk of complications due to surgical stress. Dexmedetomidine, an alpha-2 agonist, has been shown to modulate the surgical stress response and provide intraoperative hemodynamic stability, though its intraoperative use in cardiac surgeries is less explored.
Objective: This study aimed to evaluate the safety and efficacy of dexmedetomidine as an anesthetic adjuvant in CABG surgeries.
Patients and Methods: A prospective randomized controlled trial was conducted on 50 patients undergoing CABG, divided into two groups: Group D (dexmedetomidine) and Group P (placebo). Patients in Group D received dexmedetomidine throughout surgery, while Group P received saline. Hemodynamic parameters including heart rate, systolic (SBP), and diastolic blood pressure (DBP) were measured at multiple time points. Secondary outcomes included cortisol levels, opioid requirements, and incidence of postoperative cardiac complications.
Results: Dexmedetomidine significantly reduced heart rate and blood pressure at critical surgical milestones (P < 0.001). Mean SBP and DBP were lower in Group D compared to Group P, as was the need for vasodilators (12% vs. 64%, P < 0.001). Opioid requirements were reduced by 30% in Group D (mean fentanyl dose: 7.64 ± 1.58 μg/kg vs. 10.4 ± 1.44 μg/kg in Group P, P < 0.001). Postoperative cortisol levels were also significantly lower in Group D (P < 0.001).
Conclusion: Dexmedetomidine provides enhanced hemodynamic stability, reduces opioid requirements, and attenuates the stress response during CABG surgery, demonstrating its potential as an effective anesthetic adjuvant.