Effect of intraoperative use of dexmedetomidine on anesthetic requirements and time to tracheal extubation in elective adult heart surgery patients. A retrospective cohort study

Background and Objectives: Scientific literature about the effects of intraoperative use of dexmedetomidine on anesthetic requirements and time to tracheal extubation in elective adult heart surgery patients is limited. Methods: A retrospective cohort study in adult patients who underwent uncomplicated elective heart surgery was performed. 103 adult patients who received intraoperative dexmedetomidine (DEX cohort) were matched with 97 patients who did not receive intraoperative dexmedetomidine (control cohort). Matching by age, gender and type of heart surgery was done. Intraoperative requirements of anesthetics, tracheal extubation in the operating room and time to tracheal extubation in the ICU were extracted from their medical charts. Results: Both cohorts had similar demographic and preoperative characteristics. DEX cohort received smaller intraoperative anesthetic doses of fentanyl (3.2 mg/kg ± 1.3 vs control 12.5 mg/kg ± 5.9, p= 0.0001), thiopental (3.4 mg/kg ± 1.5 vs control 4.0 mg/kg ± 1.6, p= 0.018), and pancuronium (6.5 mg ± 2.3 vs control 8.0 mg ± 1.8, p= 0.0001). Frequency of intraoperative use of thiopental was low in DEX cohort patients compared with control group (81.6 % vs control 97.9%, p= 0.0001), as midazolam (22.3 % vs control 67%, p= 0.0001) and pancuronium (47.6 % vs control 98%, p= 0.0001). Time to tracheal extubation was shorter in DEX cohort (197 ± 118 min vs control 314 ± 265 min, p= 0.002). Tracheal extubation in the operating room was more frequent in the DEX cohort (46.6% vs control 9.3%, p= 0.0001). Postoperative hospital and UCI lengths of stay were similar in both cohorts.Conclusions: Intraoperative use of dexmedetomidine as coadjuvant of fentanylisoflurane based anesthesia for elective heart surgery in adult patients could reduce anesthetic requirements and facilitate early postoperative tracheal extubation.