Abstract Background: The myocardial protective property of dexmedetomidine with propofol-based total intravenous anesthesia (TIVA) is controversial in the literature. Hence, we conducted a study to evaluate the effect of adding dexmedetomidine to propofol on cardiac biomarkers, including cardiac troponin-I (cTn-I), creatine kinase-MB (CK-MB), and interleukin-6 (IL-6). Methods: A total of 52 patients, aged between 18 and 80 years, scheduled for open heart surgery were randomized into two groups. Patients in Group P received an infusion of propofol, and patients in Group PD received dexmedetomidine with propofol during surgery. The comparison of cTn-I was the primary objective, and the comparison of CK-MB level and IL-6 levels, need for inotropic support, intraoperative propofol consumption, time to extubation, postoperative delirium, duration of intensive care unit (ICU) and hospital stay, 30-day survival, and major adverse cardiovascular events within 3 postoperative days were secondary objectives. Results: The demographic parameters were comparable between groups. Patients in Group PD had significantly less increase in cTn-I, CK-MB, and IL-6 levels ( P < 0.001). Group PD had less total propofol consumption (0.50 g vs. 0.80 g, P < 0.001), less duration of ICU stays ( P < 0.001), less duration of hospital stays ( P = 0.002), less vasoinotropic score ( P = 0.00), less delirium in the postoperative period ( P < 0.001), and significantly less time for extubation ( P = 0.003). Survival at 30 days and the occurrence of major cardiovascular events within 3 postoperative days showed no significant differences among study groups. Conclusion: Dexmedetomidine offers cardioprotective properties when used with propofol-based TIVA, along with reduced ICU and hospital stay, but there is no long-term benefit in terms of morbidity and mortality.
Sharma et al. (Thu,) studied this question.