Drugs For Attenuation of Hemodynamic Responses In Patients Undergoing Elective Off-Pump Coronary Artery Bypass Graft: A Randomized Clinical Trial

Abstract

Objective: We aimed to compare the effectiveness of esmolol (ESM) vs. dexmedetomidine (DEX) in the treatment of increased hemodynamic response during coronary artery bypass. Methods: Following the approval of the Local Committee Research and Ethics Health Research, a controlled randomized clinical trial, in patients undergoing elective coronary revascularization during off-pump coronary artery bypass surgery, was performed under standardized general anesthesia. Patients randomly received infusions of ESM 0,5 mg /kg or DEX 0,5 cg/kg/hr. Hemodynamic variables of study: heart rate and MAP were analyzed at different times: t1) baseline, t2) sternotomy, t3) time of coronary anastomosis and t4) sternal closure. Results: In group DEX, a statistic significance was found in the heart rate sternotomy (t2) p=0,004 and heart rate (t3= time of coronary anastomosis) p=0,026 and MAP during (t3) p=0,002. Conclusions: Although ESM and DEX attenuate hemodynamic response during coronary artery bypass, in the DEX group, hemodynamic stabilization was observed in heart rate and MAP during coronary artery bypass.