Department of Anesthesiology, Zhongshan City People's Hospital, Zhongshan, Guangdong, China.
Pharmacy Intravenous Admixture Services, Zhongshan City People's Hospital, Zhongshan, Guangdong, China.
Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.oa.23-00210.
The study aims to assess the effects of dexmedetomidine (Dex) pretreatment on patients during cardiac valve replacement under cardiopulmonary bypass.
For patients in the Dex group (n = 52), 0.5 μg/kg Dex was given before anesthesia induction, followed by 0.5 μg/kg/h pumping injection before aortic occlusion. For patients in the control group (n = 52), 0.125 ml/kg normal saline was given instead of Dex.
The patients in the Dex group had longer time to first dose of rescue propofol than the control group (P = 0.003). The Dex group required less total dosage of propofol than the control group (P = 0.0001). The levels of cardiac troponin I (cTnI), creatine kinase isoenzyme MB (CK-MB), malondialdehyde (MDA), and tumor necrosis factor-α (TNF-α) were lower in the Dex group than the control group at T4, 8 h after the operation (T5), and 24 h after the operation (T6) (P <0.01). The Dex group required less time for mechanical ventilation than the control group (P = 0.003).
The study suggests that 0.50 µg/kg Dex pretreatment could reduce propofol use and the duration of mechanical ventilation, and confer myocardial protection without increased adverse events during cardiac valve replacement.
本研究旨在评估心脏瓣膜置换术患者在体外循环下心包内给予右美托咪定（Dex）预处理的效果。
Dex 组（n=52）患者在麻醉诱导前给予 0.5μg/kg Dex，在主动脉阻断前给予 0.5μg/kg/h 推注。对照组（n=52）患者给予 0.125ml/kg 生理盐水代替 Dex。
Dex 组患者首次使用解救性异丙酚的时间长于对照组（P=0.003）。Dex 组患者所需的异丙酚总剂量少于对照组（P=0.0001）。与对照组相比，Dex 组在 T4（术后 4 小时）、T5（术后 8 小时）和 T6（术后 24 小时）时心肌肌钙蛋白 I（cTnI）、肌酸激酶同工酶 MB（CK-MB）、丙二醛（MDA）和肿瘤坏死因子-α（TNF-α）的水平较低（P<0.01）。Dex 组患者机械通气时间少于对照组（P=0.003）。
本研究表明，0.50μg/kg Dex 预处理可减少心脏瓣膜置换术患者异丙酚的使用量和机械通气时间，并提供心肌保护作用，同时不增加不良反应。
