Abstract 10442: Perioperative Use of the Alpha-2 Adrenergic Agonist Dexmedetomidine, Reduces the Incidence of Supraventricular and Ventricular Tachyarrhythmias in Patients Undergoing Congenital Cardiac Surgery
Background: Supraventricular and ventricular tachyarrhythmias after congenital cardiac surgery are a major cause of morbidity and mortality with an incidence up to 40%. Though in our previous study we have shown that Dexmedetomidine (DEX), an alpha-2 adrenergic sedative agent can be used to treat atrial and junctional tachyarrhythmias, the present study was carried out to determine if perioperative routine use of DEX can prevent tachyarrhythmias.
Methods: Prospective observational study, comparing 2 groups; DEX group, patients who received DEX and Control group, patients who did not receive DEX perioperatively. The groups were risk stratified according to their complexity of illness using the “Aristotle score”. Intraopeartive and postoperative (up to 72 hrs) data were collected for comparison.
Results: A total of 47 patients were enrolled. DEX was started after anesthesia induction and continued through surgery and postoperative period. The mean DEX dose was 0.7 ± 0.3 mcg/kg/hr. Table 1 shows the baseline and hemodynamic results, and use of inotropic and vasoactive agents. Patients in the Control group had a higher dose requirement for antihypertensive medications and overall more patients in the Control roup needed epinephrine and antihypertensive agents. Table 2 shows the incidence of tachyarrhythmias. Ten episodes of arrhythmias were reportred in the Control (55%) vs. 1 (3.5%) in the DEX group (p=0.001). The 1 patient in the DEX group was successfully cardioverted with additional DEX.
Conclusions: Perioperative use of the alpha-2 adrenergic agonist DEX is associated with a significantly decreased incidence of supraventricular and ventricular tachyarrhythmias.
- Arrhythmias, treatment of
- Atrial arrhythmias
- Cardiac surgery
- Ventricular tachycardia
- Supraventricular tachycardia
- © 2010 by American Heart Association, Inc.