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.

Source

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

Abstract

STUDY OBJECTIVE:

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

DESIGN:

Retrospective database analysis.

SETTING:

Major academic medical center.

MEASUREMENTS:

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.

MAIN RESULTS:

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).

CONCLUSIONS:

In a large cohort of routine clinical practice cases,

dexmedetomidine administration was not associated with more hypotension or bradycardia.

 
Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s