Effects of Dexmedetomidine on Surgical Stress Responses at Patients under CABG

Bahram Fariborz Farsad¹, Maryam Janipour^2*, Ziya Totonchi³,  Farhad Gorjipour³ and Samira Oroji Omid³

¹Pharm.D, BCPS, Assistant Professor, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical sciences, Tehran, Iran.

²Department of Clinical Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran.

³Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Corresponding Author E-mail: m.janipour92@gmail.com

DOI : http://dx.doi.org/10.13005/bbra/2296

ABSTRACT: Cardiopulmonary bypass (CPB) surgery with extracorporeal circulation produce changes in the immune system and plasma levels of  inflammatory  cytokines. we hypothesize that Dexmedetomidine as an adjuvant , modulates the inflammatory response after CABG. In a prospective, randomized, blind study, 31 patients were assigned to Dexmedetomidine (Dex) group and compared with control group of 30 patients. Dex was administered at a loading dose of 0.5 µg/kg for 10 min , followed by a continuous infusion of 0.5 µg/kg per hour until the completion of CABG with CPB .  The endpoints used to assess inflammatory responses to mini – CPB were plasma tumor necrosis factor (TNF) – α , interleukin (IL – 6 ) and interleukin ( IL – 10) levels. The inflammatory markers (IL – 6 , IL – 10 , TNF – α ) were determined after Dex administration , before CPB and 24 hours after admission to ICU. Biochemical factors including glucose , creatinine , lactate , BUN, AST , ALT , LDH were determined before CPB, immediately after entering the ICU , 24 hr , 48 hr and 72 hr post admission to ICU. Hemodynamic variables were also determined. Dex group was associated with a significant reduction in urea and creatinine. There were no significant differences in glucose, lactate, liver enzymes, LDH , IL – 6, IL – 10 and hemodynamic variables.  In contrast, the surgery – induced increase in TNF – α levels in the Dex group was significantly higher compared with the control group.

KEYWORDS: Coronary Artery Bypass grafting , Cardiopulmonary Bypass.

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