ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Dexmedetomidine combined with narcotic anesthesia induction in coronary artery bypass graft surgery
Funda Gümüş1, Sıtkı Nadir Şinikoğlu1, Abdülkadir Yektaş1, Adil Polat2, Nihan Kayalar2, Kerem Erkalp1, Ayşin Alagöl1
1Department of Anaesthesiology and Reanimation, Bağcılar Training and Research Hospital, İstanbul, Turkey
2Department of Cardiovascular Surgery, Bağcılar Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2013.7813
Background: This study aims to investigate the possible effects of dexmedetomidine in combination with narcotics on anesthesia induction.

Methods: Between March 2011 and June 2011, 63 consecutive patients who underwent coronary artery bypass graft (CABG) surgery and received fentanyl (group F) or fentanyl + dexmedetomidine (group D) in our clinic were retrospectively analyzed. The level of anesthesia was monitored with bispectral index. The additional fentanyl doses and use of additional drugs were recorded at the end of induction, after endotracheal intubation, before and after skin incision, and after sternotomy. The hemodynamic parameters were recorded at the end of anesthesia induction, after intubation (1st, 3rd, 5th and 10th min), before and after skin incision and after sternotomy. Variation coefficients were calculated to compare the hemodynamic variables and bispectral index variables.

Results: The comparison of demographic parameters showed no significant difference between the groups. The fentanyl dose was lower in induction, additional administered doses and total administered doses in group D. The occurrence of hypertension was significantly higher in group F. Bispectral index levels were found to be lower and more stable in group D. The variability of systolic arterial pressure was lower in group D. Postoperative time to extubation was shorter in group D.

Conclusion: Concomitant use of dexmedetomidine and narcotics may lower opioid doses in anesthesia induction and lead to more stable hemodynamic parameters, particularly systolic arterial pressure in patients undergoing CABG. Therefore, occurrence of hypertension and fluctuations in the arterial pressure may be reduced and patients can be weaned from the ventilator more rapidly.

Keywords : Coronary artery bypass graft surgery; dexmedetomidine; opioid anesthesia
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