Effect of dexmedetomidine on development of perioperative cardiovascular events in elderly patients / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effects of dexmedetomidine on the development of perioperative cardiovascular events in elderly patients.Methods Forty-eight patients of both sexes,aged 65-85 yr,with body mass index of 19.5-25.3 kg/m2,of American Society Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective abdomninal or lower limb surgery under general anesthesia,were divided into 2 groups (n =24 each) using a random number tablegeneral anesthesia group (group G) and dexmedetomidine plus general anesthesia group (group D).In group D,dexmedetomidine was intravenously infused in a loading dose of 0.25 μg/kg over 10 min and then continuously infused at 0.2 μg · kg-1 · h-1 until 30 min before the end of surgery.The equal volume of normal saline was intravenously infused instead in group G.At 1 day before surgery and 1 and 2 days after surgery,dynamic electrocardiogram was used to monitor heart rate variability including standard deviation of normal-to-normal intervals,standard deviation of the average 5-min normal-to-normal intervals,and root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals.The development of intraoperative cardiovascular events and requirement for vasoactive drugs were recorded,and the development of cardiovascular events within 2 days after surgery was also recorded.Results Compared with group G,standard deviation of normal-to-normal intervals and standard deviation of the average 5-min normal-to-normal intervals at 1 and 2 days after surgery and root of the mean of the sum of the squares of differences between adjacent normal-to-normal intervals at 2 days after surgery were significantly increased,the total incidence of intraoperative cardiovascular events and requirement for vasoactive drugs were decreased,and the total incidence of cardiovascular events within 2 days after surgery was decreased in group D (P ＜0.05).Conclusion Dexmedetomidine can reduce the development of perioperative cardiovascular events in elderly patients.