Key result
Dexmedetomidine significantly improved the treatment rate of perioperative supraventricular tachycardia to 91.3% compared to 8.7% with midazolam in patients undergoing non-cardiac surgery.
Why the study?
Although dexmedetomidine reduces perioperative cardiovascular complications and mortality in cardiac patients, its therapeutic effect on perioperative SVT in non-cardiac surgery was unknown.
Does dexmedetomidine improve the treatment efficiency of supraventricular tachycardia compared to midazolam in adult patients undergoing elective non-cardiac surgery?
RCT (n=46)
Double-blind
Sealed envelope technique
No
Does dexmedetomidine improve the treatment efficiency of supraventricular tachycardia compared to midazolam in adult patients undergoing elective non-cardiac surgery?
Absolute Event Rate: 91.3% vs 8.7%
p-value: p=<0.001
Perioperative intravenous infusion of dexmedetomidine significantly improved the termination of supraventricular tachycardia compared to midazolam in adult patients undergoing non-cardiac surgery.
Supports dexmedetomidine for perioperative SVT termination in non-cardiac surgery; extends RCT evidence to elective adult patients.
Background: Previous studies have shown that application of dexmedetomidine (Dex) combined anesthesia during surgery can significantly reduce cardiovascular system complications and mortality of patients with cardiac disease during the perioperative period. The aim of this study was to explore the therapeutic effect of Dex on perioperative supraventricular tachycardia (SVT) in adult patients with non-cardiac surgery.Methods: Forty-six patients with SVT undergoing elective non-cardiac surgery were randomly divided into two groups, intravenously infused Dex (Dex group, 1.0 µg/kg) or midazolam (midazolam group, 0.06 mg/kg) for 10 minutes, respectively. The observation indexes containing the treatment efficiency of SVT, heart rate (HR) and and heart rate variability (HRV) including normalized low frequency power (LFnorm), normalized high frequency power (HFnorm) and LFnorm/HFnorm were recorded.Results: Treatment rates of SVT were 21/23 (91.3%) in Dex group vs 2/23 (8.7%) in midazolam group (P<0.001). In Dex group, LFnorm and LFnorm/HFnorm were decreased, and HFnorm were elevated and HR were decreased after twenty-three patients infused Dex (P < 0.05). However, there was no difference for HFnorm, LFnorm and LFnorm/HFnorm in midazolam group (P > 0.05). Conclusion: Perioperative use of dexmedetomidine has a significant therapeutic effect for SVT, and its mechanism is related to adjust cardiac autonomic nervous system and has no obvious connection with sedation.Trial registration: This trial was registered at ClinicalTrials.gov. registry number: NCT04284150 on February 13, 2020.
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Hu et al. (2020) conducted an RCT in Supraventricular tachycardia (n=46). Dexmedetomidine vs. Midazolam (0.06 mg/kg) was evaluated on Treatment efficiency of SVT (conversion to normal sinus rhythm) (p=<0.001). Dexmedetomidine significantly improved the treatment rate of perioperative supraventricular tachycardia to 91.3% compared to 8.7% with midazolam in patients undergoing non-cardiac surgery.
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