title: The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery.
abstract: OBJECTIVE
  The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia (JET) in pediatric cardiac surgery.
  
  
  METHODS
  This is a prospective, controlled study.
  
  
  METHODS
  This study was carried out at a single university hospital.
  
  
  METHODS
  Ninety patients of both sexes, American Society of Anesthesiologists Physical Status II and III, age range from 2 to 18 years, and scheduled for elective cardiac surgery for congenital and acquired heart diseases were selected as the study participants.
  
  
  METHODS
  Patients were randomized into three groups (30 each). Group I received dexmedetomidine 1 mcg/kg diluted in 100 ml of normal saline intravenously (IV) over a period of 20 min, and the infusion was completed 10 min before the induction followed by a 0.5 mcg/kg/h infusion for 72 h postoperative, Group II received amiodarone 5 mg/kg diluted in 100 ml of normal saline IV over a period of 20 min, and the infusion was completed 10 min before the induction followed by a 10-15 mcg/kg/h infusion for 72 h postoperative, and Group III received 100 ml of normal saline IV. Primary outcome was the incidence of postoperative JET. Secondary outcomes included vasoactive-inotropic score, ventilation time (VT), pediatric cardiac care unit stay, hospital length of stay, and perioperative mortality.
  
  
  RESULTS
  The incidence of JET was significantly reduced in Group I and Group II (P = 0.004) compared to Group III. Heart rate while coming off from cardiopulmonary bypass (CPB) was significantly low in Group I compared to Group II and Group III (P = 0.000). Mean VT, mean duration of Intensive Care Unit stay, and length of hospital stay (day) were significantly short (P = 0.000) in Group I and Group II compared to Group III (P = 0.000).
  
  
  CONCLUSIONS
  Perioperative use of dexmedetomidine and amiodarone is associated with significantly decreased incidence of JET as compared to placebo without significant side effects.
authors.affiliation: Department of Anesthesia and Surgical ICU, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Nagat S
authors.initials: NS
authors.lastname: El-Shmaa
authors.affiliation: Department of Pediatrics, Tanta University Hospital, Tanta, Egypt.
authors.forename: Doaa
authors.initials: D
authors.lastname: El Amrousy
authors.affiliation: Department of Cardiothoracic Surgery, Tanta University Hospital, Tanta, Egypt.
authors.forename: Wael
authors.initials: W
authors.lastname: El Feky
mesh_terms: D000638:Amiodarone / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures; D002648:Child; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D013613:Tachycardia, Ectopic Junctional / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D000638:Amiodarone