Effect of dexmedetomidine on myocardial ischemia-reperfusion injury in patients undergoing cardiac surgery with cardiopulmonary bypass: a meta-analysis / 中华麻醉学杂志

ABSTRACT

Objective To evaluata the effect of dexmedetomidine on myocardial ischemia-reperfusion injury in the patients undergoing cardiac surgery with cardiopulmonary bypassa meta-analysis.Methods We searched the China Integrated Knowledge Resources Database,Chinese Biomedical Database,Wanfang Database,Weipu,PubMed,Cochrane Library (from inception to July 2015) to identify randomized controlled trials involving dexmedetomidine-induced cardioprotection in the patients undergoing cardiac surgery with cardiopulmonary bypass.The following data were extracted from the trials includedthe mean arterial pressure and heart rate at breast bone splitting,the spontaneous recovery of heart beat during surgery,the plasma concentrations of creatine kinase-MB and cardiac troponin I at 6,24 and 48 h after surgery,and heart rate at 24 h after surgery.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.3 software.Results Twelve prospective randomized controlled trials involving 750 patients were included in this meta-analysis.The patients were divided into 2 groupsdexmedetomidine group (n =376)and control group (n =374).Compared with control group,the plasma caradiac troponin I concentrations at 6,24,and 48 h after surgery,and creatine kinase-MB concentrations at 6 and 24 h after surgery were significantly decreased,the mean arterial pressure and heart rate were decreased at breast bone splitting,heart rate was decreased at 24 h after surgery,and the percentage of spontaneous recovery of heart beat was increased in dexmedetomidine group (P＜0.05).Conclusion Dexmedetomidine can mitigate myocardial ischemia-reperfusion injury in the patients undergoing cardiac surgery with cardiopulmonary bypass.