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Sep 6, 2024Keywords:
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Main Article Content
Effect of dexmedetomidine on postoperative arrhythmias in children undergoing direct cardiac surgery with extracorporeal circulation (cardiopulmonary bypass)
Abstract
Purpose: To investigate the potential of dexmedetomidine in preventing or reducing postoperative arrhythmias in pediatric patients undergoing direct vision cardiac surgery with extracorporeal circulation (cardiopulmonary bypass (CPB)).
Methods: 62 children undergoing elective CPB cardiac surgery in Northwest Women and Children’s Hospital, Xian, China between May 2020 and June 2023 were randomly and equally divided into study and control groups. The study group received a loading dose of 1 μg/ kg dexmedetomidine followed by continuous intravenous infusion during surgery, while control group received an equivalent volume of saline infusion during surgery. Clinical data, perioperative indices (adverse reactions and intraoperative use of vasoactive drugs), levels of lactic acid, blood urea nitrogen (BUN) glomerular filtration rate (GFR), and postoperative arrhythmias were compared between the two groups at the end of the surgery.
Results: The study group showed significantly lower postoperative lactate and BUN levels compared to the control group (p < 0.05). There was no significant difference in incidence of intraoperative hypotension, bradycardia, tachycardia, and vasoactive drug use between the two groups (p > 0.05). The study group showed significantly lower incidences of postoperative nausea and vomiting as well as supraventricular and ventricular arrhythmias compared to control group (p < 0.05). Furthermore, mean arterial pressure (MAP) at T2 and T3 was significantly lower in study group compared to control group (p < 0.05).
Conclusion: Dexmedetomidine reduces postoperative lactate, BUN levels, incidence of postoperative supraventricular and ventricular arrhythmias, maintains hemodynamic stability, attenuates stress responses, preserves renal function, and decreases postoperative nausea and vomiting in pediatric CPB cardiac surgery. Large-sample multicenter clinical trials are needed for validation in further studies.
