Hemodynamic stability and analgesic effects of intravenous dexmedetomidine premedication in adult patients undergoing coronary artery bypass graft surgery

Abstract

Background: Sternotomy for coronary artery bypass surgery operation is associated with neuropathic pain, hypertension, tachycardia, agitation, and several other complications. In severe cases, the neuropathic pain may result in arrhythmia which is an important concern in cardiopulmonary bypass surgeries. Premedication for reducing the risk of hemodynamic instability, neuropathic pain, and other adverse associated consequences is very important. Objectives: We Scrutinized the effects of dexmedetomidine intravenous infusions on hemodynamic parameters and postsurgical pain in coronary artery bypass patients. Patients and Methods: A total of 60 coronary artery bypass surgery patients were recruited and were randomly allocated into two groups. 31 patients received placebo, and 29 received 1 μg/kg of dexmedetomidine 10 min before anesthesia and then 0.4 μg/kg/h of dexmedetomidine until the end of the operation. Heart rate, blood pressure, and postsurgical pain score according to the numerical rating scale were measured and recorded after recovery from anesthesia. Results: Blood pressure significantly decreased after bolus administration of dexmedetomidine which remained lower at the end of screening in most of the times. No remarkable adverse effects were observed, and its consumption was associated with significant reduction in the postsurgical pain scores as measured in 2, 4, and 6 h after surgery as well as the time of extubation. Conclusions: Infusion with 1 μg/kg of dexmedetomidine 10 min before anesthesia and 0.4 μg/kg/h of dexmedetomidine from the time of sternum closure until the extubation time appears to be effective for the maintenance of hemodynamics in coronary artery bypass surgery without remarkable adverse outcomes.

Keywords

• Cardiopulmonary bypass
• dexmedetomidine
• hemodynamics
• pain
• premedication