Effects of dexmedetomidine on cardiac electrophysiology in patients undergoing general anesthesia during perioperative period: a randomized controlled trial

Abstract

Background: Dexmedetomidine has controversial influence on cardiac electrophysiology. The aim of this study was to explore the effects of dexmedetomidine on perioperative cardiac electrophysiology in patients undergoing general anesthesia.

Methods: Eighty-one patients were randomly divided into four groups: groups D1, D2, D3 receiving dexmedetomidine 1, 1, 0.5 μg/kg over 10 min and 1, 0.5, 0.5 μg/kg/h continuous infusion respectively, and control group (group C) receiving normal saline. Twelve-lead electrocardiograms were recorded at the time before dexmedetomidine/normal saline infusion (T1), loading dose finish (T2), surgery ending (T6), 1 h (T7) after entering PACU, 24 h (T8), 48 h (T9), 72 h (T10) and 1 month (T11) postoperatively. Cardiac circulation efficiency (CCE) were also recorded.

Results: Compared with group C, QTc were significantly increased at T2 in groups D1 and D2 while decreased at T7 and T8 in group D3 (P < 0.05), iCEB were decreased at T8 (P < 0.05). Compared with group D1, QTc at T2, T6, T7, T9 and T10 and iCEB at T8 were decreased, and CCE at T2-T4 were increased in group D3 significantly (P < 0.05). Compared with group D2, QTc at T2 and iCEB at T8 were decreased and CCE at T2 and T3 were increased in group D3 significantly (P < 0.05).

Conclusions: Dexmedetomidine at a loading dose of 0.5 μg/kg and a maintenance dose of 0.5 μg/kg/h can maintain stability of cardiac electrophysiology during perioperative period and has no significant adverse effects on CCE.

Trial registration: ClinicalTrials.gov NCT04577430 (Date of registration: 06/10/2020).

Keywords: Cardiac electrophysiology; Cardiac function; Dexmedetomidine; General anesthesia.

Conflict of interest statement

The authors declared that they had no competing interests.

© 2022. The Author(s).

Figures

Fig. 1

CONSORT flow diagram of enrollment

Fig. 2

ECG at different time points in four groups during the perioperative period. A Changes of ECG in group D1. B Changes of ECG in group D2. C Changes of ECG in group D3. D Changes of ECG in group C. II Leads II of the 12-lead ECG; V5 Leads V5 of the 12-lead ECG. T1: before infusion of dexmedetomidine; T2: dexmedetomidine loading dose finish; T6: surgery ending; T7: 1 h after transferring to PACU; T8: 24 h postoperatively; T9: 48 h postoperatively; T10: 72 h postoperatively; T11: 1 month postoperatively

Fig. 3

Cardiac function and hemodynamic indexes at different time points in the four groups. A Bar graphs of quantification of CCE change levels. B Bar graphs of quantification of dp/dt change levels. C Bar graphs of quantification of HR change levels. D Bar graphs of quantification of MAP change levels. E Bar graphs of quantification of SVR change levels. CCE cardiac circulation efficiency; dp/dt maximum pressure gradient; HR heart rate; MAP mean arterial blood pressure; SVR systemic vascular resistance. T1: before dexmedetomidine infusion; T2: dexmedetomidine loading dose finish; T3: surgery beginning; T4: 30 min after surgery beginning; T5: 1 h after surgery beginning; T6: surgery ending; T7: 1 h after transferring to PACU. aP < 0.05, cP < 0.01, compared with T1; bP < 0.05, dP < 0.01, compared with T2; △P < 0.05, *P < 0.01, compared with group C; #P < 0.05, ▲P < 0.01, compared with group D1; ※P < 0.05, P < 0.01, Compared with group D2