Department of Anesthesiology, the Affiliated Hospital of Yangzhou University, Yangzhou, 225012, China.
Graduate School, Dalian Medical University, Dalian, 116000, China.
BMC Anesthesiol. 2022 Aug 25;22(1):271. doi: 10.1186/s12871-022-01811-5.
Dexmedetomidine has controversial influence on cardiac electrophysiology. The aim of this study was to explore the effects of dexmedetomidine on perioperative cardiac electrophysiology in patients undergoing general anesthesia.
Eighty-one patients were randomly divided into four groups: groups D, D, D receiving dexmedetomidine 1, 1, 0.5 μg/kg over 10 min and 1, 0.5, 0.5 μg/kg/h continuous infusion respectively, and control group (group C) receiving normal saline. Twelve-lead electrocardiograms were recorded at the time before dexmedetomidine/normal saline infusion (T), loading dose finish (T), surgery ending (T), 1 h (T) after entering PACU, 24 h (T), 48 h (T), 72 h (T) and 1 month (T) postoperatively. Cardiac circulation efficiency (CCE) were also recorded.
Compared with group C, QTc were significantly increased at T in groups D and D while decreased at T and T in group D (P < 0.05), iCEB were decreased at T (P < 0.05). Compared with group D, QTc at T, T, T, T and T and iCEB at T were decreased, and CCE at T-T were increased in group D significantly (P < 0.05). Compared with group D, QTc at T and iCEB at T were decreased and CCE at T and T were increased in group D significantly (P < 0.05).
Dexmedetomidine at a loading dose of 0.5 μg/kg and a maintenance dose of 0.5 μg/kg/h can maintain stability of cardiac electrophysiology during perioperative period and has no significant adverse effects on CCE.
ClinicalTrials.gov NCT04577430 (Date of registration: 06/10/2020).
右美托咪定对心脏电生理学有争议的影响。本研究旨在探讨全身麻醉患者围手术期应用右美托咪定对心脏电生理学的影响。
81 例患者随机分为四组：D 组、D 组、D 组分别给予右美托咪定 1、1、0.5μg/kg 静脉推注 10min 后以 1、0.5、0.5μg/kg/h 持续静脉输注，对照组（C 组）给予生理盐水。分别于右美托咪定/生理盐水输注前（T）、负荷剂量结束（T）、手术结束（T）、PACU 后 1h（T）、24h（T）、48h（T）、72h（T）和术后 1 个月（T）记录 12 导联心电图。同时记录心脏循环效率（CCE）。
与 C 组相比，D 组和 D 组 T 时 QTc 明显升高，D 组 T 和 T 时 QTc 降低（P<0.05），iCEB 于 T 时降低（P<0.05）。与 D 组相比，D 组 T、T、T、T 和 T 时 QTc 降低，T-T 时 CCE 升高（P<0.05）。与 D 组相比，D 组 T 时 QTc 和 iCEB 降低，T 和 T 时 CCE 升高（P<0.05）。
负荷剂量 0.5μg/kg、维持剂量 0.5μg/kg/h 的右美托咪定可维持围手术期心脏电生理学的稳定性，对 CCE 无明显不良影响。
ClinicalTrials.gov NCT04577430（注册日期：2020 年 10 月 6 日）。
