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

Tan, Chao; Yan, Shiting; Shen, Jie; Wu, Hao; Yu, Leyang; Wang, Ying; Tian, Shunping; Zhou, Wei; Yong, Wu; Zhang, Zhuan

doi:10.1186/s12871-022-01811-5

Cited by 8 publications

(2 citation statements)

References 43 publications

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“…28 The mechanism involved may be related to the high dose of Dex reducing norepinephrine release, inhibiting atrioventricular node and sinoatrial node functions, and exciting the vagus nerve. 29,30 Our results revealed that the incidence of bradycardia was significantly higher in Group D than in Group C, whereas use of atropine was not required, implying that no intervention was needed in most cases of bradycardia induced by low-dose Dex. It has been reported that hypotension is another common adverse effect of Dex.…”

Section: Discussionmentioning

confidence: 66%

Beneficial Effects of Low-Dose Intravenous Dexmedetomidine Premedication in Patient Undergoing Laparoscopic Cholecystectomy Under General Anesthesia: A Prospective, Double-Blind, Randomized Controlled Trial

Zheng,

Fang,

Zhang

et al. 2024

DDDT

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Dexmedetomidine (Dex) is a potent and highly selective α2-adrenergic receptor agonist. Within an appropriate dose range, Dex can effectively attenuate the surgical stress response, provide intraoperative hemodynamic stability, and improve the patient recovery quality. High-dose Dex can delay patient awakening from anesthesia and increase the incidence of bradycardia. This randomized controlled trial aimed to investigate the effects of low-dose intravenous Dex premedication in patients undergoing laparoscopic cholecystectomy (LC). Material and Methods: In total, 100 patients undergoing LC were equally randomized into Group C (premedication with saline) and Group D (premedication with 0.5 µg/kg Dex). The patients were premedicated with saline or Dex, depending on the group, before anesthesia induction. Following this, anesthesia induction and endotracheal intubation was performed, and anesthesia was maintained during surgery. Following the completion of the surgery, the patients were transferred the post-anesthesia care unit (PACU) and stayed there until they met the PACU discharge criteria. The hemodynamic parameters, consumption of anesthetics, surgical duration, postoperative awakening time, extubation time, postoperative pain, and complications were recorded. Results: No significant differences were observed in the heart rate (HR) and mean arterial pressure (MAP) between the two groups before premedication (P>0.05). The MAP and HR immediately after endotracheal intubation and immediately after extubation were significantly lower in Group D than in Group C (P<0.05 for both). The incidence of bradycardia was significantly higher in Group D than in Group C (P<0.05), while atropine was used in neither group. Propofol and remifentanil consumption was significantly lower in Group D than in Group C (P<0.05). The postoperative awakening and extubation times were significantly shorter in Group D than in Group C (P<0.05). The postoperative visual analog scale scores for pain and incidence of nausea, vomiting, and cough were significantly lower in Group D than in Group C (P<0.05 for all). Conclusion: Our data suggest that premedication with dexmedetomidine (0.5 µg/kg) before general anesthesia induction can effectively attenuate intraoperative stress response and postoperative pain, maintain perioperative hemodynamic stability, and decrease the incidence of adverse events, which might be an effective and safe anesthetic protocol during LC worthy of further clinical application.

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Section: Discussionmentioning

confidence: 66%

Beneficial Effects of Low-Dose Intravenous Dexmedetomidine Premedication in Patient Undergoing Laparoscopic Cholecystectomy Under General Anesthesia: A Prospective, Double-Blind, Randomized Controlled Trial

Zheng,

Fang,

Zhang

et al. 2024

DDDT

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“…Like corrected QT interval (QTc), iCEBc is also corrected by heart rate. As the marker of assessing risk of arrhythmia, it is widely used in the clinical research, but there is still no evidence of an association between iCEBc and its prognosis (11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of index of cardiac electrophysiological balance among US middle-aged adults

Chen

Wang

Liu

et al. 2023

Front. Cardiovasc. Med.

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BackgroundIndex of cardiac electrophysiological balance (iCEB) has been widely used in clinical practice but no studies investigated the association between iCEB and prognosis in the general population.ObjectiveTo assess the correlation between the iCEB and the prognosis in the general population.MethodsThis retrospective cohort study involved adults aged 40–65 years who participated in the Third National Health and Nutrition Examination Survey (NHANES-III) and whose electrocardiograms were in sinus rhythm. The corrected iCEB (iCEBc) was the ratio of corrected QT interval (QTc) to QRS duration, and outcomes were cardiac and all-cause mortality. Cox proportional hazards regression model was used to identify the associations of iCEBc with end point. The value of iCEBc for predicting adverse events was evaluated by reclassification and discrimination analyses.ResultsAmong 5,010 participants (mean age 51.10 ± 7.67 years, 52.5% female), 3,454 (68.9%) were Non-Hispanic White. The mean iCEBc was 4.45 ± 0.56. A total of 2,147 deaths were recorded during a median follow-up of 319 months. The adjusted model shown iCEBc was an independent risk factor for all-cause death. The iCEBc was linearly correlated with all-cause mortality and the optimal cutoff value was 4.57 in males and 4.98 in females. In the resultant model, prolonged iCEBc remained independently associated with a higher rate of mortality (HR: 1.25; 95% CI: 1.11–1.42) and cardiac death (HR: 1.34; 95% CI: 1.04–1.71). Among the complete study population or the group with normal QTc interval, the performance of the predictive model after addition of iCEBc was not weaker than the model after the addition of prolonged QTc.ConclusionElevated iCEBc (male ≥4.57 and female ≥4.98) is an independent risk factor for cardiac or all-cause death among the middle-age adults. The clinical application value of iCEBc is firmly based on basic physiological principles and its application deserves further attention.

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Insight into Cardioprotective Effects and Mechanisms of Dexmedetomidine

Jiang,

Xiong,

Yang

et al. 2024

Cardiovasc Drugs Ther

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

Cited by 8 publications

References 43 publications

Beneficial Effects of Low-Dose Intravenous Dexmedetomidine Premedication in Patient Undergoing Laparoscopic Cholecystectomy Under General Anesthesia: A Prospective, Double-Blind, Randomized Controlled Trial

Beneficial Effects of Low-Dose Intravenous Dexmedetomidine Premedication in Patient Undergoing Laparoscopic Cholecystectomy Under General Anesthesia: A Prospective, Double-Blind, Randomized Controlled Trial

Prognostic value of index of cardiac electrophysiological balance among US middle-aged adults

Insight into Cardioprotective Effects and Mechanisms of Dexmedetomidine

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