The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery

Objective: The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia (JET) in pediatric cardiac surgery. Design: This is a prospective, controlled study. Setting: This study was carried out at a single un...

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Main Authors: Nagat S El-Shmaa, Doaa El Amrousy, Wael El Feky
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Annals of Cardiac Anaesthesia
Subjects:
Online Access:http://www.annals.in/article.asp?issn=0971-9784;year=2016;volume=19;issue=4;spage=614;epage=620;aulast=El-Shmaa
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spelling doaj-987e58a0a4d54ed98f30b8e2e4461f052020-11-24T22:44:04ZengWolters Kluwer Medknow PublicationsAnnals of Cardiac Anaesthesia0971-97842016-01-0119461462010.4103/0971-9784.191564The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgeryNagat S El-ShmaaDoaa El AmrousyWael El FekyObjective: The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia (JET) in pediatric cardiac surgery. Design: This is a prospective, controlled study. Setting: This study was carried out at a single university hospital. Subjects and Methods: Ninety patients of both sexes, American Society of Anesthesiologists Physical Status II and III, age range from 2 to 18 years, and scheduled for elective cardiac surgery for congenital and acquired heart diseases were selected as the study participants. Interventions: Patients were randomized into three groups (30 each). Group I received dexmedetomidine 1 mcg/kg diluted in 100 ml of normal saline intravenously (IV) over a period of 20 min, and the infusion was completed 10 min before the induction followed by a 0.5 mcg/kg/h infusion for 72 h postoperative, Group II received amiodarone 5 mg/kg diluted in 100 ml of normal saline IV over a period of 20 min, and the infusion was completed 10 min before the induction followed by a 10–15 mcg/kg/h infusion for 72 h postoperative, and Group III received 100 ml of normal saline IV. Primary outcome was the incidence of postoperative JET. Secondary outcomes included vasoactive-inotropic score, ventilation time (VT), pediatric cardiac care unit stay, hospital length of stay, and perioperative mortality. Measurements and Main Results: The incidence of JET was significantly reduced in Group I and Group II (P = 0.004) compared to Group III. Heart rate while coming off from cardiopulmonary bypass (CPB) was significantly low in Group I compared to Group II and Group III (P = 0.000). Mean VT, mean duration of Intensive Care Unit stay, and length of hospital stay (day) were significantly short (P = 0.000) in Group I and Group II compared to Group III (P = 0.000). Conclusion: Perioperative use of dexmedetomidine and amiodarone is associated with significantly decreased incidence of JET as compared to placebo without significant side effects.http://www.annals.in/article.asp?issn=0971-9784;year=2016;volume=19;issue=4;spage=614;epage=620;aulast=El-ShmaaAmiodarone; Children; Dexmedetomidine; Junctional ectopic tachycardia; Postoperative arrhythmia
collection DOAJ
language English
format Article
sources DOAJ
author Nagat S El-Shmaa
Doaa El Amrousy
Wael El Feky
spellingShingle Nagat S El-Shmaa
Doaa El Amrousy
Wael El Feky
The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery
Annals of Cardiac Anaesthesia
Amiodarone; Children; Dexmedetomidine; Junctional ectopic tachycardia; Postoperative arrhythmia
author_facet Nagat S El-Shmaa
Doaa El Amrousy
Wael El Feky
author_sort Nagat S El-Shmaa
title The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery
title_short The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery
title_full The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery
title_fullStr The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery
title_full_unstemmed The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery
title_sort efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery
publisher Wolters Kluwer Medknow Publications
series Annals of Cardiac Anaesthesia
issn 0971-9784
publishDate 2016-01-01
description Objective: The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia (JET) in pediatric cardiac surgery. Design: This is a prospective, controlled study. Setting: This study was carried out at a single university hospital. Subjects and Methods: Ninety patients of both sexes, American Society of Anesthesiologists Physical Status II and III, age range from 2 to 18 years, and scheduled for elective cardiac surgery for congenital and acquired heart diseases were selected as the study participants. Interventions: Patients were randomized into three groups (30 each). Group I received dexmedetomidine 1 mcg/kg diluted in 100 ml of normal saline intravenously (IV) over a period of 20 min, and the infusion was completed 10 min before the induction followed by a 0.5 mcg/kg/h infusion for 72 h postoperative, Group II received amiodarone 5 mg/kg diluted in 100 ml of normal saline IV over a period of 20 min, and the infusion was completed 10 min before the induction followed by a 10–15 mcg/kg/h infusion for 72 h postoperative, and Group III received 100 ml of normal saline IV. Primary outcome was the incidence of postoperative JET. Secondary outcomes included vasoactive-inotropic score, ventilation time (VT), pediatric cardiac care unit stay, hospital length of stay, and perioperative mortality. Measurements and Main Results: The incidence of JET was significantly reduced in Group I and Group II (P = 0.004) compared to Group III. Heart rate while coming off from cardiopulmonary bypass (CPB) was significantly low in Group I compared to Group II and Group III (P = 0.000). Mean VT, mean duration of Intensive Care Unit stay, and length of hospital stay (day) were significantly short (P = 0.000) in Group I and Group II compared to Group III (P = 0.000). Conclusion: Perioperative use of dexmedetomidine and amiodarone is associated with significantly decreased incidence of JET as compared to placebo without significant side effects.
topic Amiodarone; Children; Dexmedetomidine; Junctional ectopic tachycardia; Postoperative arrhythmia
url http://www.annals.in/article.asp?issn=0971-9784;year=2016;volume=19;issue=4;spage=614;epage=620;aulast=El-Shmaa
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