title: Efficacy of Prophylactic Dexmedetomidine in Preventing Postoperative Junctional Ectopic Tachycardia After Pediatric Cardiac Surgery.
abstract: Postoperative junctional ectopic tachycardia is one of the most serious arrhythmias that occur after pediatric cardiac surgery, difficult to treat and better to be prevented. Our aim was to assess the efficacy of prophylactic dexmedetomidine in preventing junctional ectopic tachycardia after pediatric cardiac surgery.
  
  
  
  A prospective controlled study was carried out on 90 children who underwent elective cardiac surgery for congenital heart diseases. Patients were randomized into 2 groups. Group I (dexmedetomidine group): 60 patients received dexmedetomidine; Group II (Placebo group): 30 patients received the same amount of normal saline intravenously. The primary outcome was the incidence of postoperative junctional ectopic tachycardia. Secondary outcomes included bradycardia, hypotension, vasoactive inotropic score, ventilation time, pediatric cardiac care unit stay, length of hospital stay, and perioperative mortality. The incidence of junctional ectopic tachycardia was significantly reduced in the dexmedetomidine group (3.3%) compared with the placebo group (16.7%) withP<0.005. Heart rate while coming off cardiopulmonary bypass was significantly lower in the dexmedetomidine group (130.6±9) than the placebo group (144±7.1) withP<0.001. Mean ventilation time, and mean duration of intensive care unit and hospital stay (days) were significantly shorter in the dexmedetomidine group than the placebo group (P<0.001). However, there was no significant difference between the 2 groups as regards mortality, bradycardia, or hypotension (P>0.005).
  
  
  
  Prophylactic use of dexmedetomidine is associated with significantly decreased incidence of postoperative junctional ectopic tachycardia in children after congenital heart surgery without significant side effects.
authors.affiliation: Pediatric Department, Tanta University Hospital, Tanta, Egypt doaamoha@yahoo.com.
authors.forename: Doaa Mohamed
authors.initials: DM
authors.lastname: El Amrousy
authors.affiliation: Department of Anesthesia & Surgical ICU, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Nagat S
authors.initials: NS
authors.lastname: Elshmaa
authors.affiliation: Department of Anesthesia & Surgical ICU, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Kashlan
authors.affiliation: Pediatric Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Samir
authors.initials: S
authors.lastname: Hassan
authors.affiliation: Pediatric Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elsanosy
authors.affiliation: Pediatric Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Nahed
authors.initials: N
authors.lastname: Hablas
authors.affiliation: Pediatric Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Shimaa
authors.initials: S
authors.lastname: Elrifaey
authors.affiliation: Cardiothoracic Surgery Department, Tanta University Hospital, Tanta, Egypt.
authors.forename: Wael
authors.initials: W
authors.lastname: El-Feky
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000008:administration & dosage; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013613:Tachycardia, Ectopic Junctional / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D020927:Dexmedetomidine
keywords: children; dexmedetomidine; postoperative junctional ectopic tachycardia