Effects and adverse reactions of different doses of dexmedetomidine on heart valve replacement surgery
10.3760/cma.j.cn341190-20240520-00593
- VernacularTitle:不同剂量右美托咪定在心脏瓣膜置换术中的应用效果及不良反应的比较
- Author:
Yuting WU
1
;
Shan FU
1
Author Information
1. 汉中市中心医院麻醉科，汉中 723000
- Publication Type:Journal Article
- Keywords:
Heart valve prosthesis implantation;
Extracorporeal circulation;
Preanesthetic medication;
Myocardial reperfusion injury;
Intraoperative complications;
Pos
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(2):222-227
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects and adverse reactions of different doses of dexmedetomidine in patients undergoing cardiopulmonary bypass (CPB) for heart valve replacement surgery.Methods:A prospective study was conducted on 110 patients who underwent elective heart valve replacement surgery under cardiopulmonary bypass at Hanzhong Central Hospital from January 2021 to December 2023. This study used a randomized controlled trial design. The patients were randomly assigned to a control group ( n = 55) and an observation group ( n = 55) using a random number table. The control group received intravenous dexmedetomidine at a dose of 0.4 μg·kg -1·h -1 after anesthesia induction, while the observation group received intravenous dexmedetomidine at a dose of 0.2 μg·kg -1·h -1. Various surgical parameters (CPB duration, aortic cross-clamp time, total operative time, blood loss, and the rate of spontaneous cardiac rhythm recovery), pre- and post-operative levels of key cardiac biomarkers (B-type natriuretic peptide, creatine kinase-MB, cardiac troponin T, soluble ST2, and heart-type fatty acid binding protein), and the incidence of adverse reactions that occurred during surgery and within 6 hours after surgery were compared between the two groups. Results:There were no statistically significant differences between the two groups regarding CPB duration, aortic cross-clamp time, total operative time, blood loss, or rate of spontaneous cardiac rhythm recovery ( t = 0.38, 0.90, -0.48, -0.67, χ2 = 0.04, all P > 0.05). The levels of B-type natriuretic peptide, creatine kinase-MB, cardiac troponin T, soluble ST2, and heart-type fatty acid binding protein measured within 24 hours after surgery were significantly higher than those measured before surgery ( t = -11.72, -12.77, 8.80, 8.92, -15.73, -12.34, -31.03, -37.27, -8.64, -7.92, all P < 0.05). However, no significant differences in these indices were observed between the two groups (all P > 0.05). The incidence of adverse reactions that occurred during surgery and within 6 hours after surgery was significantly lower in the observation group than in the control group [1.82% (1/55) vs. 14.55% (8/55), 5.45% (3/55) vs. 18.18% (10/55), χ2 = 4.36, 4.27, both P < 0.05]. Conclusions:Dexmedetomidine at both doses of 0.2 μg·kg -1·h -1 and 0.4 μg·kg -1·h -1 can be used for heart valve replacement surgery, with the former having a lower incidence of adverse reactions.
