Perioperative intravenous corticosteroids reduce incidence of atrial fibrillation following cardiac surgery: a randomized study.
OBJECTIVE
Corticosteroids decrease side effects after noncardiac elective surgery. A randomized, double blinded, placebo-controlled study was plan to test the hypothesis that standard doses of dexamethasone (6X2) would decrease the incidence of atrial fibrillation (AF) following cardiac surgery.


METHODS
A total of 185 patients undergoing coronary revascularization surgery were enrolled in this clinical study. The anesthetic management was standardized in all patients. Dexamethasone (6 mg/ml) or saline (1 ml) was administered after the induction of anesthesia and a second dose of the same study drug was given on the morning after surgery. The incidence of AF was determined by analyzing the first 72 hours of continuously recorded electrocardiogram records after cardiac surgery, to determine the incidence and severity of postoperative side effects.


RESULTS
The incidence of 48 hours postoperative AF was significantly lower in the Dexamethasone group (21/ 92[37.5%]) than in the placebo group (35/92 [62.5%], adjusted hazard ratio, 2.07; 95% confidence interval, 1.09-3.95 (P<0.05). Compared with placebo, patients receiving dexamethasone did not have higher rates of superficial or deep wound infections, or other major complications.


CONCLUSIONS
Prophylactic short-term dexamethasone administration in patients undergoing coronary artery bypasses grafting significantly reduced postoperative atrial fibrillation.
Anesthesia Technology Department, School of allied Health Sciences, Tehran University of Medical Sciences, Tehran, Iran. abbaszad@sina.tums.ac.ir
Monir
M
Abbaszadeh
Zahid Hussain
ZH
Khan
Fariborze
F
Mehrani
Hammid
H
Jahanmehr
D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003907:Dexamethasone / Q000008:administration & dosage*; D004812:Epidemiologic Methods; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control
D005938:Glucocorticoids; D003907:Dexamethasone