Role of dexmedetomidine in myocardial protection during beating coronary artery bypass grafting.

  • Dr. Alpesh Sarvaia Senior Resident, Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Centre, B. J. Medical College, Ahmedabad, Gujarat. India
  • Dr. Jigisha Pujara Associate Professor, Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Centre, B. J. Medical College, Ahmedabad, Gujarat. India
  • Dr. Varsha Sarvaiya Professor, Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Centre, B. J. Medical College, Ahmedabad, Gujarat. India
  • Dr Ms. Himani Pandya Research Associate Department of Research, U.N. Mehta Institute of Cardiology and Research Centre, B. J. Medical College, Ahmedabad, Gujarat. India
  • Dr. Visharad Trivedi Assistant Professor, Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Centre, B. J. Medical College, Ahmedabad, Gujarat. India
  • Dr. Sunil Kumar Ninama Assistant Professor, Department of Cardiac Anesthesia, U.N. Mehta Institute of Cardiology and Research Centre, B. J. Medical College, Ahmedabad, Gujarat. India
  • Dr Mr. Himanshu Acharya Research Fellow, Department of Research, U.N. Mehta Institute of Cardiology and Research Centre, B. J. Medical College, Ahmedabad, Gujarat. India
Keywords: Myocardial, Ischemia, Arrhythmias

Abstract

Background: On-pump CABG is associated with a high risk of myocardial injuries and other complications that result into myocardial ischemia and arrhythmias. OPCAB surgery may reduce, although not entirely eliminate, these myocardial injuries. This prospective study was designed to determine whether the intraoperative use of Dexmedetomidine could reduce the incidence of myocardial injuries after off pump CABG.

Methods: A total of 100 patients who underwent off-pump coronary artery bypass surgery were included and randomly divided into Dexmedetomidine treated and Control groups (groups B and A, respectively) 50 patients in each groups. Following the first vascular anastomosis grafting, the patients in group B received a loading dose of 0.5 μg/kg/10min of Dexmedetomidine via central venous catheter followed by a continuous infusion of 0.5 μg/kg/hr of Dexmedetomidine. The infusion was discontinued at the end of surgery. In group A, 0.9% physiological saline was infused using identical methods to group B.

Results: The primary outcomes measured included serum levels of cardiac biomarkers like CPK-MB & Trop I. Secondary outcomes included hemodynamic stability, ischemia or arrhythmia events & post-operative ICU stay. Dexmedetomidine use significantly reduced postoperative CPK-MB (26.38 ± 7.11 v/s 30.48 ± 9.84, P=0.019) & Trop I (0.678 ± 0.742 v/s 1.011 ± 0.67, P=0.021) at 24 & 48 hours respectively. Intraoperative dexmedetomidine therapy also reduced the risk of overall complications.

Conclusion: Intra operative administration of low-dose dexmedetomidine reduces myocardial damage during off-pump coronary artery bypass grafting surgery as indicated by significantly decreased level of cardiac biochemical markers, CK-MB and cTnI post-operatively.

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Role of dexmedetomidine in myocardial protection during beating coronary artery bypass grafting.
CITATION
DOI: 10.17511/ijmrr.2017.i02.13
Published: 2017-02-28
How to Cite
1.
Sarvaia A, Pujara J, Sarvaiya V, Pandya H, Trivedi V, Kumar Ninama S, Acharya H. Role of dexmedetomidine in myocardial protection during beating coronary artery bypass grafting. Int J Med Res Rev [Internet]. 2017Feb.28 [cited 2024Mar.28];5(2):176-87. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/821
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