Effects of different doses of dexmedetomidine on hemodynamics in patients undergoing off-pump coronary artery bypass grafting / 医学研究生学报

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.