Hemodynamic impact of dexmedetomidine administration in 15,656 noncardiac surgical cases

J Clin Anesth. 2012 Apr 5. [Epub ahead of print]

Hemodynamic impact of dexmedetomidine administration in 15,656 noncardiac surgical cases.


Department of Anesthesiology, Duke University, Durham, NC 27710, USA.



To assess the hemodynamic impact of dexmedetomidine administration in a large cohort of patients undergoing routine noncardiac surgery.


Retrospective database analysis.


Major academic medical center.


A valid electronic preoperative history and physical record and electronic perioperative anesthesia record of all adults undergoing noncardiothoracic procedures of > 60 minutes duration between January 2007 and September 2008 were reviewed. The primary composite endpoint was systolic blood pressure < 80 mmHg for > 5 minutes, heart rate < 40 bpm for > 5 minutes, or administration of vasoconstrictors (> 500 μg of phenylephrine by bolus or infusion or any epinephrine) or atropine intraoperatively.


A total of 15,656 cases, of whom 2,688 (17%) received dexmedetomidine preoperatively or intraoperatively and 12,968 (83%) did not receive dexmedetomidine, was identified. A significantly higher percentage of patients in the dexmedetomidine group met the composite endpoint criteria (27% vs 19%, P < 0.0001). However, there was no significant difference in the overall incidence of intraoperative hypotension (5.3% dexmedetomidine, 6% no dexmedetomidine) or bradycardia (0.4% in both groups). Dexmedetomidine patients received more phenylephrine or atropine (23% vs 15%, P < 0.0001).


In a large cohort of routine clinical practice cases,

dexmedetomidine administration was not associated with more hypotension or bradycardia.


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