Dexmedetomidine as an anesthetic adjuvant in cardiac surgery: a cohort study
Rev. bras. cir. cardiovasc
;
31(3): 213-218, May.-June 2016. tab, graf
Article
Dans Anglais
| LILACS
| ID: lil-796126
ABSTRACT
ABSTRACT Objective:
α-2-agonists cause sympathetic inhibition combined with parasympathetic activation and have other properties that could be beneficial during cardiac anesthesia. We evaluated the effects of dexmedetomidine as an anesthetic adjuvant compared to a control group during cardiac surgery.Methods:
We performed a retrospective analysis of prospectively collected data from all adult patients (> 18 years old) undergoing cardiac surgery. Patients were divided into two groups, regarding the use of dexmedetomidine as an adjuvant intraoperatively (DEX group) and a control group who did not receive α-2-agonist (CON group).Results:
A total of 1302 patients who underwent cardiac surgery, either coronary artery bypass graft or valve surgery, were included; 796 in the DEX group and 506 in the CON group. Need for reoperation (2% vs. 2.8%, P=0.001), type 1 neurological injury (2% vs. 4.7%, P=0.005) and prolonged hospitalization (3.1% vs. 7.3%, P=0.001) were significantly less frequent in the DEX group than in the CON group. Thirty-day mortality rates were 3.4% in the DEX group and 9.7% in the CON group (P<0.001). Using multivariable Cox regression analysis with in hospital death as the dependent variable, dexmedetomidine was independently associated with a lower risk of 30-day mortality (odds ratio [OR]=0.39, 95% confidence interval [CI] 0.24-0.65, P≤0.001). The Logistic EuroSCORE (OR=1.05, 95% CI 1.02-1.10, P=0.004) and age (OR=1.03, 95% CI 1.01-1.06, P=0.003) were independently associated with a higher risk of 30-day mortality.Conclusion:
Dexmedetomidine used as an anesthetic adjuvant was associated with better outcomes in patients undergoing coronary artery bypass graft and valve surgery. Randomized prospective controlled trials are warranted to confirm our results.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Soins postopératoires
/
Pontage aortocoronarien
/
Dexmédétomidine
/
Valvulopathies
/
Adjuvants des anesthésiques
Type d'étude:
Etude d'étiologie
/
Etude d'incidence
/
Étude observationnelle
/
Facteurs de risque
Limites du sujet:
Adulte très âgé
/
Femelle
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Rev. bras. cir. cardiovasc
Thème du journal:
Cardiologie
/
Chirurgie générale
Année:
2016
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Faculdade de Medicina de São José do Rio Preto/BR
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