Key result
Dexmedetomidine administration during thoracoscopic-assisted thoracic surgery decreased maximum intraoperative heart rate and diastolic pressure, lowered cTnI levels, and shortened hospital stay.
Why the study?
This study was conducted to clarify the protective role of dexmedetomidine in thoracoscopic-assisted thoracic surgery, including its effects on intraoperative heart rate, blood pressure, and myocardial injury markers.
Does dexmedetomidine improve perioperative hemodynamics and myocardial protection in patients undergoing thoracoscopic-assisted thoracic surgery?
RCT
Does dexmedetomidine improve perioperative hemodynamics and myocardial protection in patients undergoing thoracoscopic-assisted thoracic surgery?
Preoperative and intraoperative administration of dexmedetomidine in thoracic surgery may improve hemodynamic stability and offer myocardial protection, potentially shortening hospital stays.
Dexmedetomidine was associated with hemodynamic stability, lower cTnI, and shorter stays in thoracic surgery; leaves open whether RCTs will confirm benefit.
BACKGROUND This study aimed to clarify the protective role of dexmedetomidine in thoracoscopic-assisted thoracic surgery (TATS), including control of the intraoperative heart rate, blood pressure, and myocardial injury markers. MATERIAL AND METHODS The patients who underwent TATS were divided into 2 equal groups: the dexmedetomidine group (dexmedetomidine pumped at 0.5 µg/kg for >10 min before the administration of anesthesia and at 0.5 µg/kg in the maintenance period) and the control group (pumped normal saline for >10 min before the administration of anesthesia). The data recorded for each patient were heart rate (preoperative, maximum intraoperative, and minimum intraoperative), systolic and diastolic blood pressure, intraoperative hemodynamic data, and intraoperative cardiovascular drugs administered. An enzyme-linked immunosorbent assay was performed to assess the postoperative levels of cardiac troponin I (cTnI), creatine kinase isoenzyme, myoglobin, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). RESULTS There were no significant differences in the age, sex, body height, body weight, American Society of Anesthesiologists classification grade, resection mode, operation time, ejection fraction, basal heart rate, and systolic and diastolic blood pressure of the 2 groups. In the dexmedetomidine group, the patients' maximum intraoperative heart rate and diastolic pressure decreased, and the postoperative hospital stay period was shorter. The postoperative peripheral blood test for the dexmedetomidine group showed higher NT-proBNP levels and lower cTnI levels. CONCLUSIONS Preoperative administration of dexmedetomidine can benefit hemodynamic stability, protect the cardiovascular system in the intraoperative and postoperative periods, and shorten postoperative hospitalization.
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Li et al. (2021) conducted an RCT in Thoracoscopic-assisted thoracic surgery (TATS). Dexmedetomidine vs. Normal saline was evaluated on Perioperative hemodynamics and myocardial injury markers. Dexmedetomidine administration during thoracoscopic-assisted thoracic surgery decreased maximum intraoperative heart rate and diastolic pressure, lowered cTnI levels, and shortened hospital stay.
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