Anesthesia

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Alpha-2 adrenergic agonists for the prevention of cardiac complications among patients undergoing surgery
Cochrane Reviews, 10/20/09

Wijeysundera DN et al. – In 31 studies that involved 4578 adult participants the authors found that alpha–2 adrenergic agonists may have some important benefits. During surgery on the major blood vessels (also called vascular surgery) they reduced the risk of dying or having a heart attack. When used during open–heart surgery they reduced the risk of poor blood flow to the heart. However, alpha–2 adrenergic agonists also had some important side–effects. Patients had a greater risk of having low blood pressures or low heart rates when given an alpha–2 adrenergic agonist. The authors concluded that although these results are encouraging more studies are needed. These studies should include more patients so that we can better determine whether alpha–2 adrenergic agonists can safely prevent heart–related complications. The studies should also determine whether one medicine (clonidine, dexmedetomidine, or mivazerol) is better than another, which specific patients would benefit from these medicines, and whether it is safe or beneficial to combine alpha–2 adrenergic agonists with other heart medicines.

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