title: Hemodynamic impact of dexmedetomidine administration in 15,656 noncardiac surgical cases.
abstract: OBJECTIVE
  To assess the hemodynamic impact of dexmedetomidine administration in a large cohort of patients undergoing routine noncardiac surgery.
  
  
  METHODS
  Retrospective database analysis.
  
  
  METHODS
  Major academic medical center.
  
  
  METHODS
  A valid electronic preoperative history and physical record and electronic perioperative anesthesia record of all adults undergoing noncardiothoracic procedures of > 60 minutes duration between January 2007 and September 2008 were reviewed. The primary composite endpoint was systolic blood pressure < 80 mmHg for > 5 minutes, heart rate < 40 bpm for > 5 minutes, or administration of vasoconstrictors (> 500 μg of phenylephrine by bolus or infusion or any epinephrine) or atropine intraoperatively.
  
  
  RESULTS
  A total of 15,656 cases, of whom 2,688 (17%) received dexmedetomidine preoperatively or intraoperatively and 12,968 (83%) did not receive dexmedetomidine, was identified. A significantly higher percentage of patients in the dexmedetomidine group met the composite endpoint criteria (27% vs 19%, P < 0.0001). However, there was no significant difference in the overall incidence of intraoperative hypotension (5.3% dexmedetomidine, 6% no dexmedetomidine) or bradycardia (0.4% in both groups). Dexmedetomidine patients received more phenylephrine or atropine (23% vs 15%, P < 0.0001).
  
  
  CONCLUSIONS
  In a large cohort of routine clinical practice cases, dexmedetomidine administration was not associated with more hypotension or bradycardia.
authors.affiliation: Department of Anesthesiology, Duke University, Durham, NC 27710, USA.
authors.forename: Rebecca Y
authors.initials: RY
authors.lastname: Klinger
authors.forename: William D
authors.initials: WD
authors.lastname: White
authors.forename: Betsy
authors.initials: B
authors.lastname: Hale
authors.forename: Ashraf S
authors.initials: AS
authors.lastname: Habib
authors.forename: Elliott
authors.initials: E
authors.lastname: Bennett-Guerrero
mesh_terms: D000046:Academic Medical Centers; D058647:Adrenergic alpha-2 Receptor Agonists / Q000009:adverse effects / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D001285:Atropine / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects*; D001919:Bradycardia / Q000453:epidemiology / Q000209:etiology; D016208:Databases, Factual; D020927:Dexmedetomidine / Q000009:adverse effects / Q000494:pharmacology*; D004837:Epinephrine / Q000494:pharmacology; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010656:Phenylephrine / Q000494:pharmacology; D012189:Retrospective Studies; D014662:Vasoconstrictor Agents / Q000494:pharmacology
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D014662:Vasoconstrictor Agents; D010656:Phenylephrine; D020927:Dexmedetomidine; D001285:Atropine; D004837:Epinephrine