الفهرس | Only 14 pages are availabe for public view |
Abstract Rationale and background: Cardiac surgery is characterized by microcirculatory alterations and reduced organ perfusion, due to a combination of the surgery itself, anesthesia, hypothermia and micro-emboli formation that occur during the procedure. Dexmedetomidine was proved to attenuate the microcirculatory derangements evoked by experimental sepsis. Furthermore, it could prevent alterations of intestinal microcirculation induced by surgical stress and pain in a novel rat model. However, the effect of dexmedetomidine on microcirculation during cardiac surgery is still unproven. Objectives: To explore the possible effects of dexmedetomidine infusion on sublingual microcirculation in patients undergoing on-pump coronary artery bypass graft surgery. Patients and methods: This randomized, controlled double blind study included 70 adult patients undergoing elective on-pump coronary artery bypass graft surgeries. All patients received a standard general anaesthesia then they were randomly allocated to receive either saline infusion (control group n=35) or dexmedetomidine infusion 0.5mic/kg/min (dexmedetomidine group n=35) during CBP. Microcirculation was studied with side-stream dark field (SDF) imaging at three times; Immediately before starting CBP (T0) , 30 min after initiation of bypass (T1), and 30 min after weaning from bypass (T2). Serum lactate, cardiac output, vasopressor dose, mean arterial pressure and central venous pressure were reported at predetermined time assessment points |