Use of dexmedetomidine for fast-track anesthesia in noncomplex pediatric cardiac surgery

IntroductionFast-track anesthesia technique is now an important aspect for reducing or eliminating the adverse effects of prolonged postoperative ventilation together with reducing ICU and hospital length of stay. This study was conducted to evaluate the effect of using dexmedetomidine as an adjuvant drug for fast-track technique in pediatric cardiac surgery.Patients and methodsSixty patients of both sexes with ages ranging from 1 to 12 years indicated for correction of noncomplex congenital heart diseases with cardiopulmonary bypass (CPB) were included in this study. After standard inhalational induction using sevoflurane for all patients, they were randomly classified into two groups of 30 each. In the dexmedetomidine group (group D), the patients received an initial bolus dose of dexmedetomidine (0.4 mg/kg) over 10 min, followed by continuous infusion of 0.5 mg/kg/h until the end of CPB. In the propofol group (group P) the patients received an initial bolus dose of propofol (2 mg/kg) over 30 s, followed by infusion at rate of 0.5 mg/kg/min until the end of CPB.ResultsThere were significant differences between the two groups (P < 0.05). As regards hemodynamics, heart rate was higher in the propofol group, whereas mean arterial pressure was higher in the dexmedetomidine group. Moreover, total dose of fentanyl, time of extubation in ICU, postoperative pain score, and need for postoperative analgesia were significantly higher in the propofol group.ConclusionDexmedetomidine helps in fast-track anesthesia in pediatric cardiac surgery and has many desirable effects that encourage its use in the perioperative period.