The influence of different dose dexmedetomidine on the myocardial damage and haemodynamics in patients received cardiac valvular replacement under cardiopulmonary bypass
ZHAO Feng
ZHANG Yan
Abstract：Objective To investigate the influence of different dose dexmedetomidine on the myocardial damage and haemodynamics in patients received cardiac valvular replacement operation under cardiopulmonary bypass (CPB). Methods 84 patients with rheumatic heart disease from Jan 2013 to Dec 2015 in Heze Municipal Hospital were chosen and randomly divided into C group, D1 group and D2 group. After anesthesia induction, D1 group were given 0.5μg/kg dexmedetomidine i.v, and 0.5μg/kg.h intravenous infusion to end of operation; D2 group were given1.0μg/kg dexmedetomidine i.v, and 0.5μg/kg.h intravenous infusion to end of operation; the C group were given same volume saline at uniform velocity. Markers of myocardial injury and hemodynamic indexes of three groups were compared. Results The general information, CPB time, aortic cross clamping time, rate of beating automatic recovery, intraoperative bleeding and dosage of sufentanil had no significant difference (P>0.05). The creatine kinase (CK-MB), heart-type fatty acid binding protein (H-FABP) and cardiac troponin -I (cTnI) of three groups at the time before 10 min of CPB stop, end of the surgery, after surgery for 6 h, 24 h were obvious higher than before giving dexmedetomidine (P<0.05); while CK-MB, H-FABP of D1 and D2 groups after surgery for 6h, 24h were obvious lower than C group (P<0.05); cTnl of D1 and D2 group at CPB stop before 10 min, end of the surgery, after surgery for 6 h, 24 h were obvious lower than C group (P<0.05); heart rate (HR) of C group at T2, T3, T5 were significant elevated (P<0.05). Compared with T0, the HR of D1 group was significant lower at T1 (P<0.05), higher at T5 (P<0.05), and had no significant differences at T2-T4 (P>0.05). While HR of D2 group at T1-T4 was obvious lower, it was significant higher at T5 (P<0.05). Mean arterial pressure (MAP) of C group at T1-T5 were significant lower than T0 (P<0.05); MAP of D1, D2 group had no significant difference (P>0.05). Conclusion Giving 0.5μg/kg dexmedetomidine after anesthesia induction can reduce myocardial damage after CPB, and maintain hemodynamic stability before and after CPB.
Keywords：HaemodynamicsCardiac valvular replacement operationMyocardial damageHemodynamics
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 567-570 )