title: Dexmedetomidine as anesthetic adjunct for fast tracking and pain control in off-pump coronary artery bypass.
abstract: OBJECTIVE
  This study was designed to determine the efficacy of dexmedetomidine (a highly selective alpha-2 agonist) in achieving fast tracking and improved postoperative pain control in off-pump coronary artery bypass (OPCAB) patients.
  
  
  METHODS
  THIRTY PATIENTS SCHEDULED FOR ELECTIVE OPCAB WERE PROSPECTIVELY RANDOMIZED INTO TWO GROUPS: Group I (15 patients) started dexmedetomidine at 0.5 ug/kg/hour after the induction of anesthesia; this was reduced to 0.3 ug/kg/hour on admission in the cardiac intensive care unit and continued for 12 hours post extubation. Group II (15 patients) received a similar volume and infusion rate of normal saline. Visual analog scale (VAS) of 10-100 was explained thoroughly to the patients during the preoperative visit. Postoperative pain was managed with morphine. The total dose of morphine was recorded. Extubation time and VAS was recorded every two hours for 12 hours post extubation.
  
  
  RESULTS
  Extubation time in group I was 72±8 minutes and 186±22 minutes in group II. Mean total use of narcotics in group II was 23.5±20.7 mg compared to 11.4±6.3 mg in group I. VAS median figures were lower at all data points in group I than in group II.
  
  
  CONCLUSIONS
  Dexmedetomidine showed an effective and safe profile as an anesthetic adjunct in OPCAB, achieving fast tracking of patients and higher quality of pain control with a lower consumption of narcotics.
authors.affiliation: Department of Anesthesia, Faculty of Medicine, Ain Shams University, Egypt, King Fahad Specialist Hospital, Saudi Arabia.
authors.forename: Mohamed Essam
authors.initials: ME
authors.lastname: Abdel-Meguid
keywords: Dexmedetomidine; fast tracking; off-pump coronary artery bypass; postoperative pain