Bharati Saswata, Pal Anirban, Biswas Chaitali, Biswas Rajasree
Department of Anaesthesiology, Calcutta National Medical College, Kolkata, India.
Acta Anaesthesiol Taiwan. 2011 Dec;49(4):165-7. doi: 10.1016/j.aat.2011.11.010. Epub 2011 Dec 19.
Dexmedetomidine has predictable, complex, and negative cardiovascular effects that lead to additional adverse effects such as bradycardia and hypotension in up to 42% of patients and might cause profound left ventricular dysfunction and refractory shock. Usually, these temporary effects can be successfully counteracted with atropine, ephedrine, and volume supplementation. Clinicians need to be well informed about the potential of dexmedetomidine to cause bradycardia, which may progress to pulseless electrical activity, particularly in patients older than 50 years and patients with cardiac abnormalities. Here, we report the clinical characteristics of six patients who were scheduled for various neurosurgical procedures within a period of three months and suffered from cardiac arrest following dexmedetomidine administration. We urge clinicians to take caution against the negative effects of dexmedetomidine, especially when it is used in patients older than 50 years with underlying cardiac disease and in combination with cardiodepressant drugs.
右美托咪定具有可预测的、复杂的负面心血管效应，可导致高达42%的患者出现额外的不良反应，如心动过缓和低血压，并可能引起严重的左心室功能障碍和难治性休克。通常，这些暂时的效应可用阿托品、麻黄碱和补充容量成功对抗。临床医生需要充分了解右美托咪定导致心动过缓的可能性，这可能会进展为无脉电活动，特别是在50岁以上的患者和有心脏异常的患者中。在此，我们报告了6例患者的临床特征，这些患者在三个月内计划接受各种神经外科手术，并在给予右美托咪定后发生心脏骤停。我们敦促临床医生对右美托咪定的负面影响保持警惕，尤其是当它用于50岁以上有潜在心脏病的患者以及与心脏抑制药物联合使用时。
