Dexmedetomidine; an adjuvant drug for fast track technique in pediatric cardiac surgery

Abstract

Background: Simple surgical procedures in pediatric open cardiac surgery can be planned for early extubation by using dexmedetomidine alpha2 agonist. Early extubation is associated with shortening of postoperative ventilation and intensive care unit length of stay. The aim of this study was to examine the effects of dexmedetomidine on recovery profile, ICU length of stay, analgesic needs, and hospital stay in pediatric patients undergoing elective correction of congenital heart diseases using CPB. Methods: Forty patients with age ranging from 2–10 years of either sex submitted for elective correction of simple congenital heart diseases undergoing CPB. All patients were premedicated in preoperative area with intramuscular 0.1 mg/kg midazolam and 0.015 mg/kg atropine sulfate. Patients were randomly classified into one of two equal groups (n = 20). In the Dex group, patients received an initial bolus dose of dexmedetomidine (0.4 μg/kg) over 10 min, followed by continuous infusion of 0.5 μg/kg/hr. In the control group, patients received an initial bolus dose of saline over 10 min, followed by continuous infusion of 0.5 μg/kg/hr. Results: MAP, HR, the total dose of intra-operative fentanyl, vasodilator needs, time of extubation, pain score, ICU length of stay and hospital stay were significantly higher in the control group when compared with DEX group. Also in control group these were significant decrease in HR and MAP relative to baseline. There was significant increase in duration of inotropic support in control group than DEX group. Conclusion: Dexmedetomidine is a short-acting alpha2-adrenoceptor agonist with many desirable clinical benefits that encourage its use in the perioperative period. Dexmedetomidine has anesthesia-sparing effects, it decreases MAP, HR and with reasonable analgesic effect.

Keywords

• Fast-tracking
• CPB
• Dexmedetomidine
• Postoperative ventilation