Effects of different doses of dexmedetomidine on hemodynamics in patients undergoing off-pump coronary artery bypass grafting
10.16571/j.cnki.1008-8199.2016.03.014
- VernacularTitle:不同剂量右美托咪定对非体外循环冠状动脉旁路移植术中血流动力学的影响
- Author:
Wei LUO
;
Yingjie SUN
;
Xiaoyu LIU
;
Yang YU
;
Kang LIU
;
Weiyan LI
- Publication Type:Journal Article
- Keywords:
Dexmedetomidine;
Coronary artery bypass;
Off pump;
Hemodynamics
- From:
Journal of Medical Postgraduates
2016;29(3):290-294
- CountryChina
- Language:Chinese
-
Abstract:
(1.Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, Jiang-su, China;2.Department of Anesthesiology, General Hospital of Shenyang Military Region, PLA, Shenyang 110000, China)
le-blind, 60 patients scheduled for OPCABG were randomly divided into 4 groups: control group( group C) and 3 dexmedetomidine group(group D1、D2、D2).Patients in each group received saline or dexmedetomidine 0.2μg/kg, 0.4μg/kg, 0.6μg/kg respectively. Hemodynamic variables such as HR、MAP、CVP、MPAP、PCWP、SVRI and PVRI were recorded after entering into the operationroom ( T0 ) , before the anesthesia induction( T1 ) , at 5 minutes after tracheal intubation ( T2 ) , during the sternotomy( T3 ) , at the end of an-astomosis of left anterior descending(T4), at the end of anastomosis of right coronary artery or 1eft circum flex coronary artery(T5) and after operation ( T6 ) .Body tempreture and urine volume were recorded during the operation.Total quantity of analgesics consumption and heart adverse reaction( bradyarrhythmia, tachycardia, hypotension, hypertension etc) were also recorded. Results At T2 -T6 , there was a significant decline in HR, MAP, SVRI, PVRI and CI in group D2 and group D3 compared with group C (P<0.05).SVRI and PVRI in group C and group D2 significantly increased at T3 -T6 compared with those at at T0(P<0.05).At T2 and T6, HR and MAP in group group D2 signicantly increased compared with group D3([57 ±6]times/min vs [52 ±4] times/min, [72 ±7]mmHg vs [63 ±5]mmHg;[72 ±5]times/min vs [55 ±6]times/min, [68 ±5]mmHg vs [63 ±5]mmHg)].At T4 -T6, significant difference was found in CI, SVRI and PVRI between group D2and group D3(P<0.05).In comparison to group C, hypertension, tachycardia in-cidence, noradrenaline amount and isosorbide mononitrate amount declined significant in group D2and group D3(P<0.05);hypoten-sion and bradycardia incidence increased significantly while isosorbide mononitrate amount reduced significantly(P <0.05). Conclusion In OPCABG, dexmedetomidine infused at 0.4μg/(kg· h) after a loading dose of 0.5μg/(kg· 10 min) is useful in maintaining stable hemodynamics which contributes to oxygen balance and reduces myocardium injury in patients.
