Perioperative Administered Dexmedetomidine On Outcomes In Patients Undergoing Cardiac Surgery

Background Dexmedetomidine is widely used during surgery. Recent studies have demonstrated that dexmedetomidine administered perioperatively is associated with lower postoperative mortality and complications in patients undergoing cardiac surgery for up to one year. This study was to investigate the effects of dexmedetomidine during cardiac surgery in Chinese patients.Methods A retrospective review was conducted of 1477 consecutive patients who underwent cardiac surgery at our institution. Of these patients,1077 received dexmedetomidine during their surgery (dexmedetomidine group) and 400 did not (control group). All patients were followed for one year. The in-hospital outcomes were compared using multiple logistic regression models with the outcome measure as the dependent variable and patient characteristics and operative variables as independent variables. Kaplan-Meier curves and log rank tests were used to compare long-term survival between groups. Hazard ratios (HR) were estimated by the Cox proportional hazards regression models. To estimate the results, their short- and long-term outcomes were compared by propensity-matching adjustment to reduce treatment selectmen bias.Result. The patients in the dexmedetomidine group presented with a greater incidence of a history of BMI(25.1±3.46 vs 24.5±3.35, P=0.002) and hypertension(53.8% vs 47.5%, P=0.032). We found an association between dexmedetomidine use and reduction in postoperative atrial fibrillation after adjusting for differences in baseline risk factors with multiple logistic regression models(Adjusted OR 0.57;95%CI 0.33-0.97; P 0.037) and propensity matching (2.50% vs 6.02%;P 0.01). However, the risk of perioperative mortality and cardiovascular complications were not significantly different between the two groups.Conclusions. Dexmedetomidine administered perioperatively reduced postoperative atrial fibrillation, but was not effective in managing short and long-term mortality or cardiovascular complications in a Chinese population.Dexmedetomidine is a potent and highly selective α 2-adrenoreceptor agonist currently utilized for continuous infusion in the intensive care unit (ICU) and clinical anesthesia.Dexmedetomidine offers remarkable pharmacological properties including sedation, anxiolysis, and analgesia with the unique characteristic to cause no respiratory depression. In addition it posses sympatholytic and antinociceptive effects that allow hemodynamic stability during surgical stimulation.