Hemodynamics in Coronary Artery Bypass Surgery: Effects of Intraoperative Dexmedetomidine administration
DOI:
https://doi.org/10.48047/Keywords:
Coronary artery bypasses surgery, dexmedetomidine, hemodynamics, intraoperative management, cardiac surgery, mean arterial pressure, cardiac output.Abstract
Background
Hemodynamic stability is crucial during coronary artery bypass grafting (CABG) surgery to
reduce perioperative complications. Dexmedetomidine, an alpha-2 adrenergic agonist, has
been increasingly used for its sedative, analgesic, and sympatholytic properties. This study
aims to evaluate the effects of intraoperative dexmedetomidine administration on hemodynamic parameters during CABG surgery.
Materials and Methods
A randomized controlled trial was conducted on 120 patients undergoing elective CABG
surgery. Patients were randomly assigned into two groups: Group D (dexmedetomidine, n=60)
and Group C (control, n=60). Group D received a loading dose of dexmedetomidine (0.5 µg/kg)
followed by a maintenance infusion of 0.4 µg/kg/h until the end of surgery. Group C received
an equivalent volume of saline as placebo. Hemodynamic parameters, including heart rate
(HR), mean arterial pressure (MAP), and cardiac output (CO), were recorded at baseline, after
induction, during cardiopulmonary bypass, and postoperatively. Statistical analysis was
performed using ANOVA and t-tests.
Results
The administration of dexmedetomidine significantly reduced HR and MAP compared to the
control group. At the end of surgery, Group D showed a 15% reduction in HR (p<0.001) and a
20% decrease in MAP (p<0.001) compared to baseline. Additionally, CO was better
maintained in Group D, with an average CO of 5.5 L/min compared to 4.8 L/min in Group C
(p=0.03). The incidence of intraoperative hypotension was lower in Group D (10%) compared
to Group C (25%) (p=0.02). Postoperative recovery was also smoother in Group D, with a
lower requirement for vasoactive drugs.
Conclusion
Intraoperative administration of dexmedetomidine during CABG surgery significantly
improves hemodynamic stability, reducing the incidence of intraoperative hypotension and
maintaining cardiac output. Dexmedetomidine may be a valuable adjunct in managing patients undergoing cardiac surgery.
