Effects of Dexmedetomidine-Fentanyl Infusion on Blood Pressure and Heart Rate during Cardiac Surgery in Children.
Background. The purpose of this study was to access the effects of dexmedetomidine-fentanyl infusion on blood pressure (BP) and heart rate (HR) before surgical stimulation, on their changes to skin incision, and on isoflurane requirement during cardiac surgery in children. Methods. This study had a prospective, randomized, and open-label design. Thirty-two children aged 1 month to 10 years undergoing surgery for repair congenital heart disease (CHD) with CPB were randomly allocated into two groups: group MDZ received midazolam 0.2 mg·kg(-1)·h(-1) and group DEX received dexmedetomidine 1 μg·kg(-1)·h(-1) during the first hour followed by half of these rates of infusions thereafter. Both group received fentanyl 10 μg·kg(-1), midazolam 0.2 mg·kg(-1) and vecuronium 0.2 mg·kg(-1) for induction. These same doses of fentanyl and vecuronium were infused during the first hour then reduced to half. The infusions started after induction and maintained until the end of surgery. Isoflurane was given briefly to control hyperdynamic response to skin incision and sternotomy. Results. In both groups, systolic blood pressure (sBP) and heart rate (HR) decreased significantly after one hour of infusion of the anesthetic solutions, but there were significantly less increase in diastolic blood pressure, sBP, and HR, and less patients required isoflurane supplementation to skin incision in the patients of the DEX group. Discussion. Dexmedetomidine infusion without a bolus appears to be an effective adjunct to fentanyl anesthesia in control of hemodynamic responses to surgery for repair of CHD in children.
Klamt
Jyrson Guilherme
JG
Department of Biomechanics, Medicine and Rehabilitation of the Locomotors System, Faculty of Medicine of Ribeirão Preto-USP, University of São Paulo, 14049-9005 Ribeirão Preto, SP, Brazil.
de Andrade Vicente
Walter Villela
WV
Garcia
Luis Vicente
LV
Ferreira
Cesar Augusto
CA
Anesthesiology. 2001 Feb;94(2):223-9
11176085
Ann Pharmacother. 2007 Feb;41(2):245-52
17299013
Br J Anaesth. 2005 Jun;94(6):821-4
15764627
Paediatr Anaesth. 2007 May;17(5):438-44
17474950
Anesth Analg. 2006 Jul;103(1):63-7, table of contents
16790627
Paediatr Anaesth. 2008 May;18(5):403-11
18363626
South Med J. 2004 May;97(5):451-5
15180019
Pediatr Crit Care Med. 2003 Apr;4(2):203-5
12749653
Paediatr Anaesth. 2005 Jul;15(7):616-20
15960649
Anesth Analg. 2004 Jan;98(1):153-158
14693611
Anesth Analg. 2002 Nov;95(5):1200-6, table of contents
12401594
Anesth Analg. 2006 Mar;102(3):668-75
16492813
Anesth Analg. 2002 Nov;95(5):1207-14, table of contents
12401595
Paediatr Anaesth. 2007 Jun;17(6):581-3
17498022
J Cardiothorac Vasc Anesth. 2006 Aug;20(4):515-9
16884981
Anaesth Intensive Care. 2004 Dec;32(6):741-5
15648981
Paediatr Anaesth. 2007 Feb;17(2):109-12
17238880
Tohoku J Exp Med. 2006 Oct;210(2):153-60
17023769
Anesthesiology. 1994 Apr;80(4):814-24
8024136
Anesth Analg. 2006 Jul;103(1):52-6, table of contents
16790625
Anesth Analg. 2001 Apr;92(4):882-90
11273919
J Cardiothorac Vasc Anesth. 2008 Feb;22(1):147-51
18249350
Anesth Analg. 2008 Jan;106(1):79-83, table of contents
18165557