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Published in: Journal of Anesthesia 1/2015

01-02-2015 | Review Article

Dexmedetomidine: a review of applications for cardiac surgery during perioperative period

Authors: Xiaoyu Zhang, Xuan Zhao, Yingwei Wang

Published in: Journal of Anesthesia | Issue 1/2015

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Abstract

Cardiac surgery is associated with a high incidence of cardiovascular and other complications during the perioperative period that translate into increased mortality and prolonged hospital stays. Safe comprehensive perioperative management is required to eliminate these adverse events. Dexmedetomidine is a selective α2-adrenoreceptor agonist that has been described as an ideal medication in the perioperative period of cardiac surgery. The major clinical effects of dexmedetomidine in this perioperative period can be summarized as attenuating the hemodynamic response, cardioprotective effects, antiarrhythmic effects, sedation in the ICU setting, treatment of delirium, and procedural sedation. Although there are some side effects of dexmedetomidine, it is emerging as an effective therapeutic agent in the management of a wide range of clinical conditions with an efficacious, safe profile. The present review serves as an overview update in the diverse applications of dexmedetomidine for cardiac surgery during the perioperative period.
Literature
1.
go back to reference Buck ML. Dexmedetomidine use in pediatric intensive care and procedural sedation. J Pediatr Pharmacol Ther. 2010;15(1):17–29.PubMedCentralPubMed Buck ML. Dexmedetomidine use in pediatric intensive care and procedural sedation. J Pediatr Pharmacol Ther. 2010;15(1):17–29.PubMedCentralPubMed
2.
go back to reference Munoz R, Berry D. Dexmedetomidine: promising drug for pediatric sedation? Pediatr Crit Care Med. 2005;6(4):493–4.CrossRefPubMed Munoz R, Berry D. Dexmedetomidine: promising drug for pediatric sedation? Pediatr Crit Care Med. 2005;6(4):493–4.CrossRefPubMed
3.
go back to reference Kamibayashi T, Maze M. Clinical uses of alpha-2-adrenergic agonists. Anesthesiology. 2000;93(5):1345–9.CrossRefPubMed Kamibayashi T, Maze M. Clinical uses of alpha-2-adrenergic agonists. Anesthesiology. 2000;93(5):1345–9.CrossRefPubMed
4.
go back to reference Mikawa K, Nishina K, Maekawa N, Obara H. Comparison of nicardipine, diltiazem and verapamil for controlling the cardiovascular responses to tracheal intubation. Br J Anaesth. 1996;76(2):221–6.CrossRefPubMed Mikawa K, Nishina K, Maekawa N, Obara H. Comparison of nicardipine, diltiazem and verapamil for controlling the cardiovascular responses to tracheal intubation. Br J Anaesth. 1996;76(2):221–6.CrossRefPubMed
5.
go back to reference Sulaiman S, Karthekeyan RB, Vakamudi M, Sundar AS, Ravullapalli H, Gandham R. The effects of dexmedetomidine on attenuation of stress response to endotracheal intubation in patients undergoing elective off-pump coronary artery bypass grafting. Ann Cardiac Anaesth. 2012;15(1):39–43.CrossRef Sulaiman S, Karthekeyan RB, Vakamudi M, Sundar AS, Ravullapalli H, Gandham R. The effects of dexmedetomidine on attenuation of stress response to endotracheal intubation in patients undergoing elective off-pump coronary artery bypass grafting. Ann Cardiac Anaesth. 2012;15(1):39–43.CrossRef
6.
go back to reference Menda F, Koner O, Sayin M, Ture H, Imer P, Aykac B. Dexmedetomidine as an adjunct to anesthetic induction to attenuate hemodynamic response to endotracheal intubation in patients undergoing fast-track CABG. Ann Cardiac Anaesth. 2010;13(1):16–21.CrossRef Menda F, Koner O, Sayin M, Ture H, Imer P, Aykac B. Dexmedetomidine as an adjunct to anesthetic induction to attenuate hemodynamic response to endotracheal intubation in patients undergoing fast-track CABG. Ann Cardiac Anaesth. 2010;13(1):16–21.CrossRef
7.
go back to reference Kunisawa T, Nagata O, Nagashima M, Mitamura S, Ueno M, Suzuki A, Takahata O, Iwasaki H. Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation. J Clin Anesth. 2009;21(3):194–9.CrossRefPubMed Kunisawa T, Nagata O, Nagashima M, Mitamura S, Ueno M, Suzuki A, Takahata O, Iwasaki H. Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation. J Clin Anesth. 2009;21(3):194–9.CrossRefPubMed
8.
go back to reference Kunisawa T, Ueno M, Kurosawa A, Nagashima M, Hayashi D, Sasakawa T, Suzuki A, Takahata O, Iwasaki H. Dexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass. J Anesth. 2011;25(6):818–22.CrossRefPubMed Kunisawa T, Ueno M, Kurosawa A, Nagashima M, Hayashi D, Sasakawa T, Suzuki A, Takahata O, Iwasaki H. Dexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass. J Anesth. 2011;25(6):818–22.CrossRefPubMed
9.
go back to reference Kabukcu HK, Sahin N, Temel Y, Titiz TA. Hemodynamics in coronary artery bypass surgery: effects of intraoperative dexmedetomidine administration. Anaesthesist. 2011;60(5):427–31.CrossRefPubMed Kabukcu HK, Sahin N, Temel Y, Titiz TA. Hemodynamics in coronary artery bypass surgery: effects of intraoperative dexmedetomidine administration. Anaesthesist. 2011;60(5):427–31.CrossRefPubMed
10.
go back to reference Klamt JG, Vicente WV, Garcia LV, Ferreira CA. Hemodynamic effects of the combination of dexmedetomidine-fentanyl versus midazolam-fentanyl in children undergoing cardiac surgery with cardiopulmonary bypass. Rev Bras Anestesiol. 2010;60(4):350–62.CrossRefPubMed Klamt JG, Vicente WV, Garcia LV, Ferreira CA. Hemodynamic effects of the combination of dexmedetomidine-fentanyl versus midazolam-fentanyl in children undergoing cardiac surgery with cardiopulmonary bypass. Rev Bras Anestesiol. 2010;60(4):350–62.CrossRefPubMed
11.
12.
go back to reference Cohen MC, Aretz TH. Histological analysis of coronary artery lesions in fatal postoperative myocardial infarction. Cardiovasc Pathol. 1999;8(3):133–9.CrossRefPubMed Cohen MC, Aretz TH. Histological analysis of coronary artery lesions in fatal postoperative myocardial infarction. Cardiovasc Pathol. 1999;8(3):133–9.CrossRefPubMed
13.
go back to reference Okada H, Kurita T, Mochizuki T, Morita K, Sato S. The cardioprotective effect of dexmedetomidine on global ischaemia in isolated rat hearts. Resuscitation. 2007;74(3):538–45.CrossRefPubMed Okada H, Kurita T, Mochizuki T, Morita K, Sato S. The cardioprotective effect of dexmedetomidine on global ischaemia in isolated rat hearts. Resuscitation. 2007;74(3):538–45.CrossRefPubMed
14.
go back to reference Riha H, Kotulak T, Brezina A, Hess L, Kramar P, Szarszoi O, Netuka I, Pirk J. Comparison of the effects of ketamine-dexmedetomidine and sevoflurane-sufentanil anesthesia on cardiac biomarkers after cardiac surgery: an observational study. Physiol Res. 2012;61(1):63–72.PubMed Riha H, Kotulak T, Brezina A, Hess L, Kramar P, Szarszoi O, Netuka I, Pirk J. Comparison of the effects of ketamine-dexmedetomidine and sevoflurane-sufentanil anesthesia on cardiac biomarkers after cardiac surgery: an observational study. Physiol Res. 2012;61(1):63–72.PubMed
15.
go back to reference Yoshitomi O, Cho S, Hara T, Shibata I, Maekawa T, Ureshino H, Sumikawa K. Direct protective effects of dexmedetomidine against myocardial ischemia–reperfusion injury in anesthetized pigs. Shock. 2012;38(1):92–7.CrossRefPubMed Yoshitomi O, Cho S, Hara T, Shibata I, Maekawa T, Ureshino H, Sumikawa K. Direct protective effects of dexmedetomidine against myocardial ischemia–reperfusion injury in anesthetized pigs. Shock. 2012;38(1):92–7.CrossRefPubMed
16.
go back to reference Ibacache M, Sanchez G, Pedrozo Z, Galvez F, Humeres C, Echevarria G, Duaso J, Hassi M, Garcia L, Diaz-Araya G, Lavandero S. Dexmedetomidine preconditioning activates pro-survival kinases and attenuates regional ischemia/reperfusion injury in rat heart. Biochim Biophys Acta. 2012;1822(4):537–45. Ibacache M, Sanchez G, Pedrozo Z, Galvez F, Humeres C, Echevarria G, Duaso J, Hassi M, Garcia L, Diaz-Araya G, Lavandero S. Dexmedetomidine preconditioning activates pro-survival kinases and attenuates regional ischemia/reperfusion injury in rat heart. Biochim Biophys Acta. 2012;1822(4):537–45.
17.
go back to reference Tosun Z, Baktir M, Kahraman HC, Baskol G, Guler G, Boyaci A. Does dexmedetomidine provide cardioprotection in coronary artery bypass grafting with cardiopulmonary bypass? A pilot study. J Cardiothorac Vasc Anesth. 2013;27(4):710–5.CrossRefPubMed Tosun Z, Baktir M, Kahraman HC, Baskol G, Guler G, Boyaci A. Does dexmedetomidine provide cardioprotection in coronary artery bypass grafting with cardiopulmonary bypass? A pilot study. J Cardiothorac Vasc Anesth. 2013;27(4):710–5.CrossRefPubMed
18.
go back to reference Bharati S, Pal A, Biswas C, Biswas R. Incidence of cardiac arrest increases with the indiscriminate use of dexmedetomidine: a case series and review of published case reports. Acta Anaesthesiol Taiwan. 2011;49(4):165–7.CrossRefPubMed Bharati S, Pal A, Biswas C, Biswas R. Incidence of cardiac arrest increases with the indiscriminate use of dexmedetomidine: a case series and review of published case reports. Acta Anaesthesiol Taiwan. 2011;49(4):165–7.CrossRefPubMed
19.
go back to reference Gerlach AT, Murphy CV. Dexmedetomidine-associated bradycardia progressing to pulseless electrical activity: case report and review of the literature. Pharmacotherapy. 2009;29(12):1492.CrossRefPubMed Gerlach AT, Murphy CV. Dexmedetomidine-associated bradycardia progressing to pulseless electrical activity: case report and review of the literature. Pharmacotherapy. 2009;29(12):1492.CrossRefPubMed
20.
go back to reference Zhang X, Schmidt U, Wain JC, Bigatello L. Bradycardia leading to asystole during dexmedetomidine infusion in an 18-year-old double-lung transplant recipient. J Clin Anesth. 2010;22(1):45–9.CrossRefPubMed Zhang X, Schmidt U, Wain JC, Bigatello L. Bradycardia leading to asystole during dexmedetomidine infusion in an 18-year-old double-lung transplant recipient. J Clin Anesth. 2010;22(1):45–9.CrossRefPubMed
21.
go back to reference Sichrovsky TC, Mittal S, Steinberg JS. Dexmedetomidine sedation leading to refractory cardiogenic shock. Anesth Analg. 2008;106(6):1784–6.CrossRefPubMed Sichrovsky TC, Mittal S, Steinberg JS. Dexmedetomidine sedation leading to refractory cardiogenic shock. Anesth Analg. 2008;106(6):1784–6.CrossRefPubMed
22.
go back to reference Chrysostomou C, Komarlu R, Lichtenstein S, Shiderly D, Arora G, Orr R, Wearden PD, Morell VO, Munoz R, Jooste EH. Electrocardiographic effects of dexmedetomidine in patients with congenital heart disease. Intensive Care Med. 2010;36(5):836–42.CrossRefPubMed Chrysostomou C, Komarlu R, Lichtenstein S, Shiderly D, Arora G, Orr R, Wearden PD, Morell VO, Munoz R, Jooste EH. Electrocardiographic effects of dexmedetomidine in patients with congenital heart disease. Intensive Care Med. 2010;36(5):836–42.CrossRefPubMed
23.
go back to reference Hammer GB, Drover DR, Cao H, Jackson E, Williams GD, Ramamoorthy C, Van Hare GF, Niksch A, Dubin AM. The effects of dexmedetomidine on cardiac electrophysiology in children. Anesth Analg. 2008;106(1):79–83.CrossRefPubMed Hammer GB, Drover DR, Cao H, Jackson E, Williams GD, Ramamoorthy C, Van Hare GF, Niksch A, Dubin AM. The effects of dexmedetomidine on cardiac electrophysiology in children. Anesth Analg. 2008;106(1):79–83.CrossRefPubMed
24.
go back to reference Char D, Drover DR, Motonaga KS, Gupta S, Miyake CY, Dubin AM, Hammer GB. The effects of ketamine on dexmedetomidine-induced electrophysiologic changes in children. Paediatr Anaesth. 2013;23(10):898–905.CrossRefPubMed Char D, Drover DR, Motonaga KS, Gupta S, Miyake CY, Dubin AM, Hammer GB. The effects of ketamine on dexmedetomidine-induced electrophysiologic changes in children. Paediatr Anaesth. 2013;23(10):898–905.CrossRefPubMed
25.
go back to reference Chrysostomou C, Beerman L, Shiderly D, Berry D, Morell VO, Munoz R. Dexmedetomidine: a novel drug for the treatment of atrial and junctional tachyarrhythmias during the perioperative period for congenital cardiac surgery: a preliminary study. Anesth Analg. 2008;107(5):1514–22.CrossRefPubMed Chrysostomou C, Beerman L, Shiderly D, Berry D, Morell VO, Munoz R. Dexmedetomidine: a novel drug for the treatment of atrial and junctional tachyarrhythmias during the perioperative period for congenital cardiac surgery: a preliminary study. Anesth Analg. 2008;107(5):1514–22.CrossRefPubMed
26.
go back to reference Chrysostomou C, Sanchez-de-Toledo J, Wearden P, Jooste EH, Lichtenstein SE, Callahan PM, Suresh T, O’Malley E, Shiderly D, Haney J, Yoshida M, Orr R, Munoz R, Morell VO. Perioperative use of dexmedetomidine is associated with decreased incidence of ventricular and supraventricular tachyarrhythmias after congenital cardiac operations. Ann Thorac Surg. 2011;92(3):964–72 (discussion 972). Chrysostomou C, Sanchez-de-Toledo J, Wearden P, Jooste EH, Lichtenstein SE, Callahan PM, Suresh T, O’Malley E, Shiderly D, Haney J, Yoshida M, Orr R, Munoz R, Morell VO. Perioperative use of dexmedetomidine is associated with decreased incidence of ventricular and supraventricular tachyarrhythmias after congenital cardiac operations. Ann Thorac Surg. 2011;92(3):964–72 (discussion 972).
27.
go back to reference Chrysostomou C, Morell VO, Wearden P, Sanchez-de-Toledo J, Jooste EH, Beerman L. Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia. Congenit Heart Dis. 2013;8(1):48–56.CrossRefPubMed Chrysostomou C, Morell VO, Wearden P, Sanchez-de-Toledo J, Jooste EH, Beerman L. Dexmedetomidine: therapeutic use for the termination of reentrant supraventricular tachycardia. Congenit Heart Dis. 2013;8(1):48–56.CrossRefPubMed
28.
go back to reference Ohsugi E, Nagamine Y, Ohtsuka M. The effect of dexmedetomidine in a child with intractable supraventricular tachyarrhythmia after total cavopulmonary connection. Masui. 2011;60(4):493–5.PubMed Ohsugi E, Nagamine Y, Ohtsuka M. The effect of dexmedetomidine in a child with intractable supraventricular tachyarrhythmia after total cavopulmonary connection. Masui. 2011;60(4):493–5.PubMed
29.
go back to reference Parent BA, Munoz R, Shiderly D, Chrysostomou C. Use of dexmedetomidine in sustained ventricular tachycardia. Anaesth Intensive Care. 2010;38(4):781.PubMed Parent BA, Munoz R, Shiderly D, Chrysostomou C. Use of dexmedetomidine in sustained ventricular tachycardia. Anaesth Intensive Care. 2010;38(4):781.PubMed
30.
go back to reference Delwadia S, Naguib A, Tobias JD. Dexmedetomidine controls supraventricular tachycardia following cardiac surgery in a child. World J Pediatr Congenit Heart Surg. 2012;3(3):406–9.CrossRefPubMed Delwadia S, Naguib A, Tobias JD. Dexmedetomidine controls supraventricular tachycardia following cardiac surgery in a child. World J Pediatr Congenit Heart Surg. 2012;3(3):406–9.CrossRefPubMed
31.
go back to reference LeRiger M, Naguib A, Gallantowicz M, Tobias JD. Dexmedetomidine controls junctional ectopic tachycardia during tetralogy of Fallot repair in an infant. Ann Cardiac Anaesth. 2012;15(3):224–8.CrossRef LeRiger M, Naguib A, Gallantowicz M, Tobias JD. Dexmedetomidine controls junctional ectopic tachycardia during tetralogy of Fallot repair in an infant. Ann Cardiac Anaesth. 2012;15(3):224–8.CrossRef
32.
go back to reference Shah AN, Koneru J, Nicoara A, Goldfeder LB, Thomas K, Ehlert FA. Dexmedetomidine related cardiac arrest in a patient with permanent pacemaker; a cautionary tale. Pacing Clin Electrophysiol. 2007;30(9):1158–60.CrossRefPubMed Shah AN, Koneru J, Nicoara A, Goldfeder LB, Thomas K, Ehlert FA. Dexmedetomidine related cardiac arrest in a patient with permanent pacemaker; a cautionary tale. Pacing Clin Electrophysiol. 2007;30(9):1158–60.CrossRefPubMed
33.
go back to reference Shepard SM, Tejman-Yarden S, Khanna S, Davis CK, Batra AS. Dexmedetomidine-related atrial standstill and loss of capture in a pediatric patient after congenital heart surgery. Crit Care Med. 2011;39(1):187–9.CrossRefPubMed Shepard SM, Tejman-Yarden S, Khanna S, Davis CK, Batra AS. Dexmedetomidine-related atrial standstill and loss of capture in a pediatric patient after congenital heart surgery. Crit Care Med. 2011;39(1):187–9.CrossRefPubMed
35.
go back to reference Sessler CN, Varney K. Patient-focused sedation and analgesia in the ICU. Chest. 2008;133(2):552–65.CrossRefPubMed Sessler CN, Varney K. Patient-focused sedation and analgesia in the ICU. Chest. 2008;133(2):552–65.CrossRefPubMed
36.
go back to reference Anger KE, Szumita PM, Baroletti SA, Labreche MJ, Fanikos J. Evaluation of dexmedetomidine versus propofol-based sedation therapy in mechanically ventilated cardiac surgery patients at a tertiary academic medical center. Crit Pathw Cardiol. 2010;9(4):221–6.CrossRefPubMed Anger KE, Szumita PM, Baroletti SA, Labreche MJ, Fanikos J. Evaluation of dexmedetomidine versus propofol-based sedation therapy in mechanically ventilated cardiac surgery patients at a tertiary academic medical center. Crit Pathw Cardiol. 2010;9(4):221–6.CrossRefPubMed
37.
go back to reference Barletta JF, Miedema SL, Wiseman D, Heiser JC, McAllen KJ. Impact of dexmedetomidine on analgesic requirements in patients after cardiac surgery in a fast-track recovery room setting. Pharmacotherapy. 2009;29(12):1427–32.CrossRefPubMed Barletta JF, Miedema SL, Wiseman D, Heiser JC, McAllen KJ. Impact of dexmedetomidine on analgesic requirements in patients after cardiac surgery in a fast-track recovery room setting. Pharmacotherapy. 2009;29(12):1427–32.CrossRefPubMed
38.
go back to reference Curtis JA, Hollinger MK, Jain HB. Propofol-based versus dexmedetomidine-based sedation in cardiac surgery patients. J Cardiothorac Vasc Anesth. 2013;27(6):1289–94.CrossRefPubMed Curtis JA, Hollinger MK, Jain HB. Propofol-based versus dexmedetomidine-based sedation in cardiac surgery patients. J Cardiothorac Vasc Anesth. 2013;27(6):1289–94.CrossRefPubMed
39.
go back to reference Abd Aziz N, Chue MC, Yong CY, Hassan Y, Awaisu A, Hassan J, Kamarulzaman MH. Efficacy and safety of dexmedetomidine versus morphine in post-operative cardiac surgery patients. Int J Clin Pharm. 2011;33(2):150–4.CrossRefPubMed Abd Aziz N, Chue MC, Yong CY, Hassan Y, Awaisu A, Hassan J, Kamarulzaman MH. Efficacy and safety of dexmedetomidine versus morphine in post-operative cardiac surgery patients. Int J Clin Pharm. 2011;33(2):150–4.CrossRefPubMed
40.
go back to reference Lam F, Ransom C, Gossett JM, Kelkhoff A, Seib PM, Schmitz ML, Bryant JC, Frazier EA, Gupta P. Safety and efficacy of dexmedetomidine in children with heart failure. Pediatr Cardiol. 2013;34(4):835–41.CrossRefPubMed Lam F, Ransom C, Gossett JM, Kelkhoff A, Seib PM, Schmitz ML, Bryant JC, Frazier EA, Gupta P. Safety and efficacy of dexmedetomidine in children with heart failure. Pediatr Cardiol. 2013;34(4):835–41.CrossRefPubMed
41.
go back to reference Norkiene I, Ringaitiene D, Misiuriene I, Samalavicius R, Bubulis R, Baublys A, Uzdavinys G. Incidence and precipitating factors of delirium after coronary artery bypass grafting. Scand Cardiovasc J. 2007;41(3):180–5.CrossRefPubMed Norkiene I, Ringaitiene D, Misiuriene I, Samalavicius R, Bubulis R, Baublys A, Uzdavinys G. Incidence and precipitating factors of delirium after coronary artery bypass grafting. Scand Cardiovasc J. 2007;41(3):180–5.CrossRefPubMed
42.
go back to reference Banach M, Kazmierski J, Kowman M, Okonski PK, Sobow T, Kloszewska I, Mikhailidis DP, Goch A, Banys A, Rysz J, Goch JH, Jaszewski R. Atrial fibrillation as a nonpsychiatric predictor of delirium after cardiac surgery: a pilot study. Med Sci Monit. 2008;14(5):CR286–91. Banach M, Kazmierski J, Kowman M, Okonski PK, Sobow T, Kloszewska I, Mikhailidis DP, Goch A, Banys A, Rysz J, Goch JH, Jaszewski R. Atrial fibrillation as a nonpsychiatric predictor of delirium after cardiac surgery: a pilot study. Med Sci Monit. 2008;14(5):CR286–91.
43.
go back to reference Rudolph JL, Jones RN, Levkoff SE, Rockett C, Inouye SK, Sellke FW, Khuri SF, Lipsitz LA, Ramlawi B, Levitsky S, Marcantonio ER. Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery. Circulation. 2009;119(2):229–36. Rudolph JL, Jones RN, Levkoff SE, Rockett C, Inouye SK, Sellke FW, Khuri SF, Lipsitz LA, Ramlawi B, Levitsky S, Marcantonio ER. Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery. Circulation. 2009;119(2):229–36.
44.
go back to reference Santos FS, Velasco IT, Fraguas R Jr. Risk factors for delirium in the elderly after coronary artery bypass graft surgery. Int Psychogeriatr. 2004;16(2):175–93.CrossRefPubMed Santos FS, Velasco IT, Fraguas R Jr. Risk factors for delirium in the elderly after coronary artery bypass graft surgery. Int Psychogeriatr. 2004;16(2):175–93.CrossRefPubMed
45.
go back to reference Kazmierski J, Kowman M, Banach M, Pawelczyk T, Okonski P, Iwaszkiewicz A, Zaslonka J, Sobow T, Kloszewska I. Preoperative predictors of delirium after cardiac surgery: a preliminary study. Gen Hosp Psychiatry. 2006;28(6):536–8.CrossRefPubMed Kazmierski J, Kowman M, Banach M, Pawelczyk T, Okonski P, Iwaszkiewicz A, Zaslonka J, Sobow T, Kloszewska I. Preoperative predictors of delirium after cardiac surgery: a preliminary study. Gen Hosp Psychiatry. 2006;28(6):536–8.CrossRefPubMed
46.
go back to reference Veliz-Reissmuller G, Aguero Torres H, van der Linden J, Lindblom D, M Eriksdotter Jonhagen. Pre-operative mild cognitive dysfunction predicts risk for post-operative delirium after elective cardiac surgery. Aging Clin Exp Res. 2007;19(3):172–7.CrossRefPubMed Veliz-Reissmuller G, Aguero Torres H, van der Linden J, Lindblom D, M Eriksdotter Jonhagen. Pre-operative mild cognitive dysfunction predicts risk for post-operative delirium after elective cardiac surgery. Aging Clin Exp Res. 2007;19(3):172–7.CrossRefPubMed
47.
go back to reference Chang YL, Tsai YF, Lin PJ, Chen MC, Liu CY. Prevalence and risk factors for postoperative delirium in a cardiovascular intensive care unit. Am J Crit Care. 2008;17(6):567–75.PubMed Chang YL, Tsai YF, Lin PJ, Chen MC, Liu CY. Prevalence and risk factors for postoperative delirium in a cardiovascular intensive care unit. Am J Crit Care. 2008;17(6):567–75.PubMed
48.
go back to reference Koster S, Oosterveld FG, Hensens AG, Wijma A, van der Palen J. Delirium after cardiac surgery and predictive validity of a risk checklist. Ann Thorac Surg. 2008;86(6):1883–7.CrossRefPubMed Koster S, Oosterveld FG, Hensens AG, Wijma A, van der Palen J. Delirium after cardiac surgery and predictive validity of a risk checklist. Ann Thorac Surg. 2008;86(6):1883–7.CrossRefPubMed
49.
50.
go back to reference Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr, Inouye SK, Bernard GR, Dittus RS. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004;291(14):1753–62.CrossRefPubMed Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr, Inouye SK, Bernard GR, Dittus RS. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004;291(14):1753–62.CrossRefPubMed
51.
go back to reference Milbrandt EB, Deppen S, Harrison PL, Shintani AK, Speroff T, Stiles RA, Truman B, Bernard GR, Dittus RS, Ely EW. Costs associated with delirium in mechanically ventilated patients. Crit Care Med. 2004;32(4):955–62.CrossRefPubMed Milbrandt EB, Deppen S, Harrison PL, Shintani AK, Speroff T, Stiles RA, Truman B, Bernard GR, Dittus RS, Ely EW. Costs associated with delirium in mechanically ventilated patients. Crit Care Med. 2004;32(4):955–62.CrossRefPubMed
52.
go back to reference Rizzo JA, Bogardus ST Jr, Leo-Summers L, Williams CS, Acampora D, Inouye SK. Multicomponent targeted intervention to prevent delirium in hospitalized older patients: what is the economic value? Med Care. 2001;39(7):740–52.CrossRefPubMed Rizzo JA, Bogardus ST Jr, Leo-Summers L, Williams CS, Acampora D, Inouye SK. Multicomponent targeted intervention to prevent delirium in hospitalized older patients: what is the economic value? Med Care. 2001;39(7):740–52.CrossRefPubMed
53.
go back to reference Hsu YW, Cortinez LI, Robertson KM, Keifer JC, Sum-Ping ST, Moretti EW, Young CC, Wright DR, Macleod DB, Somma J. Dexmedetomidine pharmacodynamics: part I. Crossover comparison of the respiratory effects of dexmedetomidine and remifentanil in healthy volunteers. Anesthesiology. 2004;101(5):1066–76.CrossRefPubMed Hsu YW, Cortinez LI, Robertson KM, Keifer JC, Sum-Ping ST, Moretti EW, Young CC, Wright DR, Macleod DB, Somma J. Dexmedetomidine pharmacodynamics: part I. Crossover comparison of the respiratory effects of dexmedetomidine and remifentanil in healthy volunteers. Anesthesiology. 2004;101(5):1066–76.CrossRefPubMed
54.
go back to reference Nelson LE, Lu J, Guo T, Saper CB, Franks NP, Maze M. The alpha2-adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiology. 2003;98(2):428–36.CrossRefPubMed Nelson LE, Lu J, Guo T, Saper CB, Franks NP, Maze M. The alpha2-adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiology. 2003;98(2):428–36.CrossRefPubMed
55.
go back to reference Aho M, Lehtinen AM, Erkola O, Kallio A, Korttila K. The effect of intravenously administered dexmedetomidine on perioperative hemodynamics and isoflurane requirements in patients undergoing abdominal hysterectomy. Anesthesiology. 1991;74(6):997–1002.CrossRefPubMed Aho M, Lehtinen AM, Erkola O, Kallio A, Korttila K. The effect of intravenously administered dexmedetomidine on perioperative hemodynamics and isoflurane requirements in patients undergoing abdominal hysterectomy. Anesthesiology. 1991;74(6):997–1002.CrossRefPubMed
56.
go back to reference Weinbroum AA, Ben-Abraham R. Dextromethorphan and dexmedetomidine: new agents for the control of perioperative pain. Eur J Surg. 2001;167(8):563–9.CrossRefPubMed Weinbroum AA, Ben-Abraham R. Dextromethorphan and dexmedetomidine: new agents for the control of perioperative pain. Eur J Surg. 2001;167(8):563–9.CrossRefPubMed
57.
go back to reference Maldonado JR, Wysong A, van der Starre PJ, Block T, Miller C, Reitz BA. Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics. 2009;50(3):206–17.CrossRefPubMed Maldonado JR, Wysong A, van der Starre PJ, Block T, Miller C, Reitz BA. Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics. 2009;50(3):206–17.CrossRefPubMed
58.
go back to reference Shehabi Y, Grant P, Wolfenden H, Hammond N, Bass F, Campbell M, Chen J. Prevalence of delirium with dexmedetomidine compared with morphine based therapy after cardiac surgery: a randomized controlled trial (DEXmedetomidine COmpared to Morphine-DEXCOM Study). Anesthesiology. 2009;111(5):1075–84.CrossRefPubMed Shehabi Y, Grant P, Wolfenden H, Hammond N, Bass F, Campbell M, Chen J. Prevalence of delirium with dexmedetomidine compared with morphine based therapy after cardiac surgery: a randomized controlled trial (DEXmedetomidine COmpared to Morphine-DEXCOM Study). Anesthesiology. 2009;111(5):1075–84.CrossRefPubMed
59.
go back to reference Tan JA, Ho KM. Use of dexmedetomidine as a sedative and analgesic agent in critically ill adult patients: a meta-analysis. Intensive Care Med. 2010;36(6):926–39.CrossRefPubMed Tan JA, Ho KM. Use of dexmedetomidine as a sedative and analgesic agent in critically ill adult patients: a meta-analysis. Intensive Care Med. 2010;36(6):926–39.CrossRefPubMed
60.
go back to reference Lin Y, Chen J, Wang Z. Meta-analysis of factors which influence delirium following cardiac surgery. J Card Surg. 2012;27(4):481–92.CrossRefPubMed Lin Y, Chen J, Wang Z. Meta-analysis of factors which influence delirium following cardiac surgery. J Card Surg. 2012;27(4):481–92.CrossRefPubMed
61.
go back to reference Tobias JD. Tolerance, withdrawal, and physical dependency after long-term sedation and analgesia of children in the pediatric intensive care unit. Crit Care Med. 2000;28(6):2122–32.CrossRefPubMed Tobias JD. Tolerance, withdrawal, and physical dependency after long-term sedation and analgesia of children in the pediatric intensive care unit. Crit Care Med. 2000;28(6):2122–32.CrossRefPubMed
62.
go back to reference Riihioja P, Jaatinen P, Oksanen H, Haapalinna A, Heinonen E, Hervonen A. Dexmedetomidine, diazepam, and propranolol in the treatment of ethanol withdrawal symptoms in the rat. Alcohol Clin Exp Res. 1997;21(5):804–8.CrossRefPubMed Riihioja P, Jaatinen P, Oksanen H, Haapalinna A, Heinonen E, Hervonen A. Dexmedetomidine, diazepam, and propranolol in the treatment of ethanol withdrawal symptoms in the rat. Alcohol Clin Exp Res. 1997;21(5):804–8.CrossRefPubMed
63.
go back to reference Riihioja P, Jaatinen P, Oksanen H, Haapalinna A, Heinonen E, Hervonen A. Dexmedetomidine alleviates ethanol withdrawal symptoms in the rat. Alcohol. 1997;14(6):537–44.CrossRefPubMed Riihioja P, Jaatinen P, Oksanen H, Haapalinna A, Heinonen E, Hervonen A. Dexmedetomidine alleviates ethanol withdrawal symptoms in the rat. Alcohol. 1997;14(6):537–44.CrossRefPubMed
64.
go back to reference Riihioja P, Jaatinen P, Haapalinna A, Kiianmaa K, Hervonen A. Effects of dexmedetomidine on rat locus coeruleus and ethanol withdrawal symptoms during intermittent ethanol exposure. Alcohol Clin Exp Res. 1999;23(3):432–8.CrossRefPubMed Riihioja P, Jaatinen P, Haapalinna A, Kiianmaa K, Hervonen A. Effects of dexmedetomidine on rat locus coeruleus and ethanol withdrawal symptoms during intermittent ethanol exposure. Alcohol Clin Exp Res. 1999;23(3):432–8.CrossRefPubMed
65.
go back to reference Baddigam K, Russo P, Russo J, Tobias JD. Dexmedetomidine in the treatment of withdrawal syndromes in cardiothoracic surgery patients. J Intensive Care Med. 2005;20(2):118–23.CrossRefPubMed Baddigam K, Russo P, Russo J, Tobias JD. Dexmedetomidine in the treatment of withdrawal syndromes in cardiothoracic surgery patients. J Intensive Care Med. 2005;20(2):118–23.CrossRefPubMed
66.
go back to reference Finkel JC, Elrefai A. The use of dexmedetomidine to facilitate opioid and benzodiazepine detoxification in an infant. Anesth Analg. 2004;98(6):1658–9 (table of contents).CrossRefPubMed Finkel JC, Elrefai A. The use of dexmedetomidine to facilitate opioid and benzodiazepine detoxification in an infant. Anesth Analg. 2004;98(6):1658–9 (table of contents).CrossRefPubMed
67.
go back to reference Finkel JC, Johnson YJ, Quezado ZM. The use of dexmedetomidine to facilitate acute discontinuation of opioids after cardiac transplantation in children. Crit Care Med. 2005;33(9):2110–2.CrossRefPubMed Finkel JC, Johnson YJ, Quezado ZM. The use of dexmedetomidine to facilitate acute discontinuation of opioids after cardiac transplantation in children. Crit Care Med. 2005;33(9):2110–2.CrossRefPubMed
68.
69.
go back to reference Multz AS. Prolonged dexmedetomidine infusion as an adjunct in treating sedation-induced withdrawal. Anesth Analg. 2003;96(4):1054–5 (table of contents).CrossRefPubMed Multz AS. Prolonged dexmedetomidine infusion as an adjunct in treating sedation-induced withdrawal. Anesth Analg. 2003;96(4):1054–5 (table of contents).CrossRefPubMed
70.
go back to reference Tobias JD. Dexmedetomidine to treat opioid withdrawal in infants following prolonged sedation in the pediatric ICU. J Opioid Manag. 2006;2(4):201–5.PubMed Tobias JD. Dexmedetomidine to treat opioid withdrawal in infants following prolonged sedation in the pediatric ICU. J Opioid Manag. 2006;2(4):201–5.PubMed
71.
go back to reference Frazee EN, Personett HA, Leung JG, Nelson S, Dierkhising RA, Bauer PR. Influence of dexmedetomidine therapy on the management of severe alcohol withdrawal syndrome in critically ill patients. J Crit Care. 2014;29:298–302.CrossRefPubMed Frazee EN, Personett HA, Leung JG, Nelson S, Dierkhising RA, Bauer PR. Influence of dexmedetomidine therapy on the management of severe alcohol withdrawal syndrome in critically ill patients. J Crit Care. 2014;29:298–302.CrossRefPubMed
72.
73.
go back to reference Tosun Z, Akin A, Guler G, Esmaoglu A, Boyaci A. Dexmedetomidine–ketamine and propofol–ketamine combinations for anesthesia in spontaneously breathing pediatric patients undergoing cardiac catheterization. J Cardiothorac Vasc Anesth. 2006;20(4):515–9.CrossRefPubMed Tosun Z, Akin A, Guler G, Esmaoglu A, Boyaci A. Dexmedetomidine–ketamine and propofol–ketamine combinations for anesthesia in spontaneously breathing pediatric patients undergoing cardiac catheterization. J Cardiothorac Vasc Anesth. 2006;20(4):515–9.CrossRefPubMed
74.
go back to reference Munro HM, Tirotta CF, Felix DE, Lagueruela RG, Madril DR, Zahn EM, Nykanen DG. Initial experience with dexmedetomidine for diagnostic and interventional cardiac catheterization in children. Paediatr Anaesth. 2007;17(2):109–12.CrossRefPubMed Munro HM, Tirotta CF, Felix DE, Lagueruela RG, Madril DR, Zahn EM, Nykanen DG. Initial experience with dexmedetomidine for diagnostic and interventional cardiac catheterization in children. Paediatr Anaesth. 2007;17(2):109–12.CrossRefPubMed
75.
go back to reference Mester R, Easley RB, Brady KM, Chilson K, Tobias JD. Monitored anesthesia care with a combination of ketamine and dexmedetomidine during cardiac catheterization. Am J Ther. 2008;15(1):24–30.CrossRefPubMed Mester R, Easley RB, Brady KM, Chilson K, Tobias JD. Monitored anesthesia care with a combination of ketamine and dexmedetomidine during cardiac catheterization. Am J Ther. 2008;15(1):24–30.CrossRefPubMed
76.
go back to reference Ben-Dor I, Looser PM, Maluenda G, Weddington TC, Kambouris NG, Barbash IM, Hauville C, Okubagzi P, Corso PJ, Satler LF, Pichard AD, Waksman R. Transcatheter aortic valve replacement under monitored anesthesia care versus general anesthesia with intubation. Cardiovasc Revasc Med. 2012;13(4):207–10. Ben-Dor I, Looser PM, Maluenda G, Weddington TC, Kambouris NG, Barbash IM, Hauville C, Okubagzi P, Corso PJ, Satler LF, Pichard AD, Waksman R. Transcatheter aortic valve replacement under monitored anesthesia care versus general anesthesia with intubation. Cardiovasc Revasc Med. 2012;13(4):207–10.
77.
go back to reference Barton KP, Munoz R, Morell VO, Chrysostomou C. Dexmedetomidine as the primary sedative during invasive procedures in infants and toddlers with congenital heart disease. Pediatr Crit Care Med. 2008;9(6):612–5.CrossRefPubMed Barton KP, Munoz R, Morell VO, Chrysostomou C. Dexmedetomidine as the primary sedative during invasive procedures in infants and toddlers with congenital heart disease. Pediatr Crit Care Med. 2008;9(6):612–5.CrossRefPubMed
78.
go back to reference Munro HM, Felix DE, Nykanen DG. Dexmedetomidine/ketamine for diagnostic cardiac catheterization in a child with idiopathic pulmonary hypertension. J Clin Anesth. 2009;21(6):435–8.CrossRefPubMed Munro HM, Felix DE, Nykanen DG. Dexmedetomidine/ketamine for diagnostic cardiac catheterization in a child with idiopathic pulmonary hypertension. J Clin Anesth. 2009;21(6):435–8.CrossRefPubMed
79.
go back to reference Kunisawa T, Kurosawa A, Hayashi D, Takahashi K, Kishi M, Iwasaki H. Administration of dexmedetomidine alone during diagnostic cardiac catheterization in adults with congenital heart disease: two case reports. J Anesth. 2011;25(4):599–602.CrossRefPubMed Kunisawa T, Kurosawa A, Hayashi D, Takahashi K, Kishi M, Iwasaki H. Administration of dexmedetomidine alone during diagnostic cardiac catheterization in adults with congenital heart disease: two case reports. J Anesth. 2011;25(4):599–602.CrossRefPubMed
80.
go back to reference Kunisawa T, Kurosawa A, Oikawa M, Mizobuchi M, Hayashi D, Iwasaki H. A high dose of dexmedetomidine using the BIS monitor for diagnostic and interventional cardiac catheterization in a toddler with congenital heart disease. J Anesth. 2012;26(2):254–8.CrossRefPubMed Kunisawa T, Kurosawa A, Oikawa M, Mizobuchi M, Hayashi D, Iwasaki H. A high dose of dexmedetomidine using the BIS monitor for diagnostic and interventional cardiac catheterization in a toddler with congenital heart disease. J Anesth. 2012;26(2):254–8.CrossRefPubMed
81.
go back to reference Haselman MA. Dexmedetomidine: a useful adjunct to consider in some high-risk situations. AANA J. 2008;76(5):335–9.PubMed Haselman MA. Dexmedetomidine: a useful adjunct to consider in some high-risk situations. AANA J. 2008;76(5):335–9.PubMed
82.
go back to reference Reardon DP, Anger KE, Adams CD, Szumita PM. Role of dexmedetomidine in adults in the intensive care unit: an update. Am J Health Syst Pharm. 2013;70(9):767–77.CrossRefPubMed Reardon DP, Anger KE, Adams CD, Szumita PM. Role of dexmedetomidine in adults in the intensive care unit: an update. Am J Health Syst Pharm. 2013;70(9):767–77.CrossRefPubMed
83.
go back to reference Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Proc (Bayl Univ Med Cent). 2001;14(1):13–21. Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Proc (Bayl Univ Med Cent). 2001;14(1):13–21.
Metadata
Title
Dexmedetomidine: a review of applications for cardiac surgery during perioperative period
Authors
Xiaoyu Zhang
Xuan Zhao
Yingwei Wang
Publication date
01-02-2015
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 1/2015
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-014-1857-z

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