Effects of dexmedetomidine sedation on myocardial ischemia in peripheral vascular surgery performed under epidural anaesthesia Epidural anestezi altinda periferik damar cerrahisinde deksmedetomidin sedasyonunun miyokard i̇skemisi üzerine etkisi
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.18, sa.4, ss.96-104, 2012 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 18 Sayı: 4
- Basım Tarihi: 2012
- Doi Numarası: 10.5222/gkdad.2012.096
- Dergi Adı: Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.96-104
- Anahtar Kelimeler: Dexmedetomidine, Ischemic heart disease, Myocardial protection, Peripheral vascular surgery
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet
Özet
Objective: Dexmedetomidine (dex) has beneficial effects on heart rate and provides adequate sedation during the perioperative period. We aimed to investigate the effects of dex on myocardial ischemia and postoperative analgesic requirements in peripheral vascular surgery performed under epidural anaesthesia. Material and Methods: During surgery under epidural anaesthesia, patients were allocated in 2 groups. In group D(GD), sedation was achieved with dex during surgery and in ICU for the first postoperative 24 hours. The second group (GM) received midazolam sedation during surgery. Both drug infusions were titrated to achieve a target level of sedation. Epidural anaesthesia and postoperative, analgesia were identical for two groups. Hemodynamic parameters and ECG analysis were recorded during surgery and in ICU for 48 hours. Troponin levels were measured at the beginning and postoperative 4., 8., 24., 36., and 48. hours. Visual analogue scale (VAS) scores and postoperative analgesic requirements were also noted. Results: In the GD group, heart rate was slower than the GM group at all times. Duration of ischemic episodes were significantly shorter in GD than GM. Troponin levels were found to be significantly lower in the GD group at postoperative 24., 36., and 48. hours (p<0.05). Analgesic consumption was significantly lower in the GD group than in the GM group at postoperative 24. and 48. hours (p<0.01). Conclusion: Dexmedetomidine combined to epidural anaesthesia ensured adequate sedation as midazolam. Moreover dexmedetomidine infusion was associated with lower heart rate, reduced troponin levels and reduced analgesic requirements. These effects persisted even after discontinuation of dexmedetomidine infusion.