Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Effect of dexmedetomidine on postoperative arrhythmias in children undergoing direct cardiac surgery with extracorporeal circulation (cardiopulmonary bypass)

Dandan Zhou¹, Chen Ma¹, Shi Dong¹, Xiaofei Wang¹, Xiaodong Han^2,3

¹Department of Anesthesiology, Northwest Women’s and Children’s Hospital, Xian, China; ²Department of Anesthesiology, Xian International Medical Center Hospital, Xian, China; ³Yanan University School of Medicine, Yanan, China.

For correspondence:- Xiaodong Han Email: hanxiaodong1212@163.com

Accepted: 25 July 2024 Published: 31 August 2024

Citation: Zhou D, Ma C, Dong S, Wang X, Han X. Effect of dexmedetomidine on postoperative arrhythmias in children undergoing direct cardiac surgery with extracorporeal circulation (cardiopulmonary bypass). Trop J Pharm Res 2024; 23(8):1345-1352 doi: 10.4314/tjpr.v23i8.15

© 2024 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..

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.

Keywords: Dexmedetomidine, Extracorporeal circulation, Cardiac direct vision surgery, Arrhythmia