Effect of Dexmedetomidine on Perioperative Hemodynamics and Myocardial Protection in Thoracoscopic-Assisted Thoracic Surgery

Abstract

Background This study aimed to clarify the protective role of dexmedetomidine in thoracoscopic-assisted thoracic surgery (TATS), including control of the intraoperative heart rate, blood pressure, and myocardial injury markers. Material/Methods The patients who underwent TATS were divided into 2 equal groups: the dexmedetomidine group (dexmedetomidine pumped at 0.5 μg/kg for >10 min before the administration of anesthesia and at 0.5 μg/kg in the maintenance period) and the control group (pumped normal saline for >10 min before the administration of anesthesia). The data recorded for each patient were heart rate (preoperative, maximum intraoperative, and minimum intraoperative), systolic and diastolic blood pressure, intraoperative hemodynamic data, and intraoperative cardiovascular drugs administered. An enzyme-linked immunosorbent assay was performed to assess the postoperative levels of cardiac troponin I (cTnI), creatine kinase isoenzyme, myoglobin, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Results There were no significant differences in the age, sex, body height, body weight, American Society of Anesthesiologists classification grade, resection mode, operation time, ejection fraction, basal heart rate, and systolic and diastolic blood pressure of the 2 groups. In the dexmedetomidine group, the patients’ maximum intraoperative heart rate and diastolic pressure decreased, and the postoperative hospital stay period was shorter. The postoperative peripheral blood test for the dexmedetomidine group showed higher NT-proBNP levels and lower cTnI levels. Conclusions Preoperative administration of dexmedetomidine can benefit hemodynamic stability, protect the cardiovascular system in the intraoperative and postoperative periods, and shorten postoperative hospitalization.

Effects of dexmedetomidine on cardiac electrophysiology in patients undergoing general anesthesia during perioperative period: a randomized controlled trial

“…In the current study, dp/dt in each dexmedetomidine group was significantly lower than the basic values after dexmedetomidine loading dose use, indicating that loading doses of 1 or 0.5 μg/kg could both inhibit myocardial contractility. While the dp/dt in group D 3 was significantly higher than those in groups D 1 and D 2 at 1 h in PACU and had no significant difference compared with that in group C, illustrating that lower dose of dexmedetomidine at 0.5 μg/kg/h significantly improve the cardiac prognosis, which was consistent with the previous studies [ 36 – 38 ]. Hence, lower dose dexmedetomidine in D 3 had no significant adverse effects on myocardial function during perioperative period.…”

Adoption of Dexmedetomidine in Different Doses at Different Timing in Perioperative Patients

“…Before anesthesia, patients often have decreased blood volume due to adverse emotions to surgical treatment, causing excessive changes in blood pressure and heart rate as well as reduced body tolerance. [23] suggested that Dex injection before anesthesia could effectively relieve perioperative hemodynamics and protect myocardial cells in thoracic surgery. Elgebaly et al (2020) [24] found that Dex was more effective before anesthesia.…”

Dexmedetomidine–Oxycodone combination for conscious sedation during colonoscopy in obese patients: A randomized controlled trial

“…Hemodynamic stability ensures tissue perfusion of vital organs, such as the heart and brain. Moreover, a slight decrease in heart rate reduces myocardial oxygen consumption, which may protect the myocardium [ [33] , [34] , [35] ]. Nevertheless, heart rate monitoring needs to be emphasized.…”