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Published on: September 15, 2023
Effect of dexmedetomidine on hemodynamic changes and inflammatory responses in patients undergoing off-pump
Wenqian Zhai1,2, Lieming Yang3, Peng Sun2
1Tianjin Medical University, Tianjin 300070, P.R. China.
Insights
Dexmedetomidine effectively stabilized hemodynamics and reduced inflammation in patients undergoing off-pump coronary artery bypass grafting (OPCABG). This key finding highlights its potential benefits for cardiac surgery patients.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Pharmacology
Background:
- Off-pump coronary artery bypass grafting (OPCABG) can induce significant hemodynamic and inflammatory responses.
- Managing these responses is crucial for patient outcomes.
- Dexmedetomidine is an alpha-2 adrenergic agonist with sedative and potential anti-inflammatory properties.
Purpose of the Study:
- To evaluate the impact of dexmedetomidine on hemodynamic stability.
- To assess the effect of dexmedetomidine on inflammatory markers during OPCABG.
- To determine the safety and efficacy of dexmedetomidine in this surgical context.
Main Methods:
- A randomized controlled trial involving 300 patients undergoing OPCABG.
- Patients were assigned to either a dexmedetomidine infusion group or a control group receiving saline.
- Hemodynamic parameters and inflammatory indices (IL-6, TNF-α, CRP, IL-10) were monitored and compared.
Main Results:
- Patients receiving dexmedetomidine exhibited significantly lower heart rate and mean arterial pressure compared to the control group (P<0.05).
- Pro-inflammatory markers, including interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP), were significantly reduced in the dexmedetomidine group (P<0.05).
- While IL-10 levels showed a trend, a statistically significant difference was not observed between groups.
Conclusions:
- Intravenous dexmedetomidine administration during OPCABG effectively stabilizes hemodynamic parameters.
- Dexmedetomidine demonstrates a significant anti-inflammatory effect in patients undergoing OPCABG.
- The findings support the use of dexmedetomidine for managing hemodynamics and inflammation in OPCABG procedures.
Abstract:
The aim of the present study was to determine the effect of dexmedetomidine on hemodynamic changes and inflammatory responses in patients undergoing off-pump coronary artery bypass grafting (OPCABG). A total of 300 patients about to receive OPCABG were randomized evenly into the control group (n=116) and study group (n=123). Intravenous dexmedetomidine pump infusion was administered to patients in the study group at a rate of 0.4 µg.kg-1.h-1. The control group received physiological saline at the same infusion speed. Changes in hemodynamic parameters and inflammatory indices were compared between the two groups. Hemodynamic parameters, such as the heart rate and mean arterial pressure, were lower in patients from the study group, compared with that in the control group (both P<0.05). The levels of pro-inflammatory factors, such as interleukin (IL)-6, tumor necrosis factor-α and C-reactive protein, were also reduced in the study group (P<0.05). The observed levels of IL-10 were lower in the control group compared with that in the study group, although a statistically significant difference was not achieved. Thus, the administration of dexmedetomidine in patients undergoing OPCABG stabilized hemodynamics and reduced inflammation. The present study was registered at the Chinese Clinical Trial Registry, under the trial registration number ChiCTR-OOC-15005978 (2015).
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