A randomized controlled double-blinded study of dexmedetomidate in preventing intra operative and post-operative arrythymias in pediatric congenital heart surgery

Abstract

Introduction: Dexmedetomidine, a selective α2-adrenergic agonist, is commonly used for its sedative and analgesic properties in pediatric patients undergoing cardiothoracic surgery. Despite its known benefits, the efficacy of dexmedetomidine in reducing perioperative arrhythmias remains unclear. The aim is to determine the impact of dexmedetomidine administration on the incidence of supraventricular and ventricular arrhythmias in pediatric patients undergoing cardiothoracic surgeries with cardiopulmonary bypass. Materials and Methods: This was a prospective, randomized, double-blinded controlled trial involving 56 pediatric patients (aged 6 months to 10 years) undergoing cardiothoracic procedures with CPB. Patients were randomly assigned into two groups using a computer-generated number Table: the dexmedetomidine group (Group A) received a loading dose followed by a maintenance infusion of dexmedetomidine, and the control group (Group B) did not receive dexmedetomidine. Primary outcomes measured were the incidence of supraventricular and ventricular arrhythmias. Secondary outcomes included the duration of mechanical ventilation, hemodynamic stability, length of CICU and hospital stay, and perioperative mortality. Results: There were no statistically significant differences in the incidence of supraventricular (p-values ranging from 0.75 to 0.88) or ventricular arrhythmias (p-values from 0.76 to 0.85) between the dexmedetomidine and control groups. Similarly, there were no significant differences in secondary outcomes such as duration of mechanical ventilation, CICU and hospital stay, or adverse events like bradycardia and hypotension. Conclusion: Dexmedetomidine administration during the perioperative period does not significantly reduce the incidence of supraventricular and ventricular arrhythmias in pediatric patients undergoing cardiothoracic surgeries. While it is effective for sedation and maintaining hemodynamic stability, its specific role in preventing perioperative arrhythmias may be limited and warrants further investigation.