Prophylactic dexmedetomidine significantly reduced the incidence of postoperative junctional ectopic tachycardia compared with placebo (3.3% vs 16.7%, P<0.005) in children after congenital heart surgery.
RCT (n=90)
2:1
Does prophylactic dexmedetomidine prevent postoperative junctional ectopic tachycardia in children undergoing elective cardiac surgery for congenital heart diseases?
Prophylactic dexmedetomidine significantly reduces the incidence of postoperative junctional ectopic tachycardia and shortens ICU and hospital stays in children undergoing congenital heart surgery.
Absolute Event Rate: 3.3% vs 16.7%
p-value: p=<0.005
Background Postoperative junctional ectopic tachycardia is one of the most serious arrhythmias that occur after pediatric cardiac surgery, difficult to treat and better to be prevented. Our aim was to assess the efficacy of prophylactic dexmedetomidine in preventing junctional ectopic tachycardia after pediatric cardiac surgery. Methods and Results A prospective controlled study was carried out on 90 children who underwent elective cardiac surgery for congenital heart diseases. Patients were randomized into 2 groups. Group I (dexmedetomidine group): 60 patients received dexmedetomidine; Group II (Placebo group): 30 patients received the same amount of normal saline intravenously. The primary outcome was the incidence of postoperative junctional ectopic tachycardia. Secondary outcomes included bradycardia, hypotension, vasoactive inotropic score, ventilation time, pediatric cardiac care unit stay, length of hospital stay, and perioperative mortality. The incidence of junctional ectopic tachycardia was significantly reduced in the dexmedetomidine group (3.3%) compared with the placebo group (16.7%) with P 0.005). Conclusion Prophylactic use of dexmedetomidine is associated with significantly decreased incidence of postoperative junctional ectopic tachycardia in children after congenital heart surgery without significant side effects.
Amrousy et al. (Wed,) conducted a rct in Congenital heart disease requiring surgery (n=90). Dexmedetomidine vs. Placebo (normal saline) was evaluated on Incidence of postoperative junctional ectopic tachycardia (p=<0.005). Prophylactic dexmedetomidine significantly reduced the incidence of postoperative junctional ectopic tachycardia compared with placebo (3.3% vs 16.7%, P<0.005) in children after congenital heart surgery.
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