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Anesth Analg 2006;103:52-56
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000217204.92904.76

PEDIATRIC ANESTHESIA

The Use of Dexmedetomidine in Pediatric Cardiac Surgery

Ahmed M. Mukhtar, MD*, Eman M. Obayah, MD{dagger}, and Amira M. Hassona{dagger}

From the Departments of Anesthesia and Intensive Care and Biochemitry, Cairo Uniersity, Egypt.

Address correspondence and reprint requests to Ahmed M. Mukhtar, MD, Faculty of Medicine, Cairo University, 2 Zaafran St from Ahmed Kamel St behind Giza Governate Alharam, Cairo, Egypt. Address e-mail to Ahmed3m2003{at}yahoo.com.

We tested dexmedetomidine, an {alpha}2 agonist, for its ability to decrease heart rate, arterial blood pressure, and neuroendocrinal responses during pediatric cardiac surgery. In a randomized, placebo-controlled study, 30 pediatric patients undergoing open heart surgery were randomly assigned to one of two equal groups. The control group received saline, whereas the treatment group (DEX group) received an initial bolus dose of dexmedetomidine (0.5 µg/kg) over 10 min, followed immediately by a continuous infusion of 0.5 µg · kg–1 · h–1. Arterial blood pressure, heart rate, and sequential concentrations of circulating cortisol, epinephrine, norepinephrine, and blood glucose were measured. Relative to baseline, arterial blood pressure and heart rate decreased significantly after the administration of dexmedetomidine through skin incision. In the control group, patients' heart rate and arterial blood pressure measures increased after skin incision until the end of bypass (P < 0.05). In both groups, plasma cortisol, epinephrine, norepinephrine, and blood glucose increased significantly relative to baseline, after sternotomy, and after bypass. However, the values were significantly higher in the control group compared with the DEX group (P < 0.05). In conclusion, intraoperative dexmedetomidine infusion attenuated the hemodynamic and neuroendocrinal response to surgical trauma and cardiopulmonary bypass in pediatric patients undergoing corrective surgery for congenital heart disease.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.