The Effects Of Dexmedetomidine On Myocardial Injury After Carotid Endarterectomy

Objective:In this study,the occurrence of myocardial injury after CEA surgery was observed,and the effect of dexmedetomidine on myocardial injury was observed,providing a clinical basis for the prevention of myocardial injury after CEA surgery.Methods:Fifty patients with carotid endarterectomy in the second hospital of HeBei medical university from March 2018 to January 2019 were selected?which of preoperative ECG showed no arrhythmia or myocardial ischemia,no limitation of age or gender?,were randomly divided into two groups:control group?group C?and dexmedetomidine group?group D?.All patients received general intravenous anesthesia.The mean daily blood pressure measured after in the hospital was recorded as the base value?T₀?,and the blood pressure and heart rate were measured and recorded after the intubation was stabilized under general anesthesia for 5min?T₁?,after carotid artery occlusion 5min?T₂?,after carotid artery opening 5min?T₃?,and after carotid artery opening 10min?T₄?;recorded duration of arterial occlusion,the time of awaken and the number and dose of vasoactive drugs were used.postoperative were monitored 24-hour ambulatory electrocardiogram and measured Troponin I on the first day after the operation.The incidence of extubation reactions at waking was recorded in both groups.The mortality rate during hospitalization was recorded.Results:1.Preoperative general informationThere were no significant differences in gender,age composition,preoperative complications,incidence of intraventricular hypertension and block time between two groups?P>0.05??Table 1?.2.Intraoperative data comparisonCompared with group C,patients in group D received less dose of vasoactive drugs during intraoperative,and use of drugs for lowering blood pressure and heart rate during Carotid artery occlusion and opening were less?P<0.05??Table 2?.Compared with T₀,the blood pressure of patients in the two groups were lower at T_1-4?P<0.05?.Compared with T₂,the blood pressure of patients in the two groups were lower at T_3-4?P<0.05?.There was no significant difference in blood pressure at T_0-4 between the two groups?Table 3,Fig 1?.3.Postoperative dataThere were no significant differences between the two groups in the incidence of postoperative ventricular arrhythmia and supraventricular arrhythmia and the average heart rate postoperative 1d?P>0.05?.Postoperative ambulatory electrocardiogram showed no significant difference in the occurrence rhythm of ST segment and T wave between the two groups?P>0.05?.The quantitative measurement of troponin I on the first day after surgery in both groups were within the normal range,and the difference was not statistically significant?P>0.05??Table 4?.4.No deaths occurred during hospitalization in two groups?P>0.05?.5.There were no significant differences in the time of recovery and extubation response between the two groups?P>0.05??Table 5?.Conclusions:Under the experimental conditions of this study,there was no myocardial injury manifested by troponin elevation,all patients had new arrhythmias and myocardial ischemia.Postoperative circulation management should be strengthened to prevent myocardial injury.In this study,there was no evidence that dexmedetomidine significantly improved myocardial ischemia after surgery.