title: Effect of dexmeditomidine on postoperative junctional ectopic tachycardia after complete surgical repair of tetralogy of Fallot: A prospective randomized controlled study.
abstract: BACKGROUND
  Incidence of junctional ectopic tachycardia (JET) after repair of tetralogy of Fallot (TOF) is 5.6-14%. Dexmeditomidine is a a-2 adrenoceptor agonist modulates the release of catecholamine, resulting in bradycardia and hypotension. These effects are being explored as a therapeutic option for the prevention of perioperative tachyarrhythmia. We undertook this study to examine possible preventive effects of dexmedetomidine on postoperative JET and its impact on the duration of ventilation time and length of Intensive Care Unit stay.
  
  
  METHODS
  After obtaining approval from the hospitals ethics committee and written informed consent from parents, this quasi-randomized trial was initiated. Of 94 patients, 47 patients received dexmedetomidine (dexmedetomidine group) and 47 patients did not receive the drug (control group).
  
  
  RESULTS
  Dexmedetomidine group had more number of complex variants like TOF with an absent pulmonary valve or pulmonary atresia (P = 0.041). Hematocrit on cardiopulmonary bypass (CPB), heart rate while coming off from CPB and inotrope score was significantly low in the dexmedetomidine group compared to control group. The incidence of JET was significantly low in dexmedetomidine group (P = 0.040) compared to control group.
  
  
  CONCLUSIONS
  Dexmedetomidine may have a potential benefit of preventing perioperative JET.
authors.affiliation: Department of Pediatric Cardiac Anaesthesia and Intensive Care, Kokilaben Dhirubhai Ambani Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
authors.forename: Shankar V
authors.initials: SV
authors.lastname: Kadam
authors.forename: Kamlesh B
authors.initials: KB
authors.lastname: Tailor
authors.forename: Snehal
authors.initials: S
authors.lastname: Kulkarni
authors.forename: Smrutiranjan R
authors.initials: SR
authors.lastname: Mohanty
authors.forename: Preetha V
authors.initials: PV
authors.lastname: Joshi
authors.forename: Suresh G
authors.initials: SG
authors.lastname: Rao
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000494:pharmacology*; D002675:Child, Preschool; D020927:Dexmedetomidine / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013613:Tachycardia, Ectopic Junctional / Q000150:complications / Q000517:prevention & control*; D013771:Tetralogy of Fallot / Q000150:complications* / Q000601:surgery*
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D020927:Dexmedetomidine