Hemodynamic impact of dexmedetomidine administration in 15,656 noncardiac surgical cases
Journal of Clinical Anesthesia, 04/26/2012
Klinger RY et al. – In a large cohort of routine clinical practice cases, dexmedetomidine administration was not associated with more hypotension or bradycardia.Methods
- A valid electronic preoperative history and physical record and electronic perioperative anesthesia record of all adults undergoing noncardiothoracic procedures of >60minutes duration between January 2007 and September 2008 were reviewed.
- The primary composite endpoint was systolic blood pressure <80mmHg for >5minutes, heart rate <40bpm for >5minutes, or administration of vasoconstrictors (>500µg of phenylephrine by bolus or infusion or any epinephrine) or atropine intraoperatively.
- A total of 15,656 cases, of whom 2,688 (17%) received dexmedetomidine preoperatively or intraoperatively and 12,968 (83%) did not receive dexmedetomidine, was identified.
- A significantly higher percentage of patients in the dexmedetomidine group met the composite endpoint criteria (27% vs 19%, P<0.0001).
- However, there was no significant difference in the overall incidence of intraoperative hypotension (5.3% dexmedetomidine, 6% no dexmedetomidine) or bradycardia (0.4% in both groups).
- Dexmedetomidine patients received more phenylephrine or atropine (23% vs 15%, P<0.0001).