Myocardial protective effect of dexmedetomidine in pediatric patients undergoing total correction of tetralogy of Fallot / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the myocardial protective effect of dexmedetomidine in the pediatric patients undergoing total correction of tetralogy of Fallot.Methods Forty ASA physical status Ⅱ] or Ⅲ pediatric patients of both sexes,aged 9 months-5 yr,weighing 7-21 kg,scheduled for elective total correction of tetralogy of Fallot under cardiopulmonary bypass,were randomly divided into 2 groups (n =20 each)control group (C group) and dexmedetomidine group (D group).Anesthesia was induced with iv injection of midazolam,sufentanil,etomidate and rocuronium.The patients were endotracheally intubated and mechanically ventilated.After intubation,dexmedetomidine was infused intravenously at 0.6 μg· kg-1 · h-1 until the end of operation in group D,while the equal volume normal saline was given instead of dexmedetomidine in group C.Venous blood samples were obtained before operation,at the end of operation and at 24 h after operation for determination of plasma TNF-α and IL-6 concentrations.The occurence of anoxic spells was recorded.Results The concentrations of plasma TNF-α and IL-6 were significantly lower at the end of operation and 24 h after operation in group D than in group C(P ＜0.05).The incidence of anoxic spells was 0 in group D,however it was 20％ in group C.Conclusion For the pediatric patients undergoing total correction of tetralogy of Fallot under cardiopulmonary bypass,dexmedetomidine infused at 0.6 μg· kg-1 · h-1 during operation can exert myocardial protective effect with clinical significance.