Effect of Dexmedetomidine in Patient with Cardiac Issues

Taylor Chuich^*
*Correspondence: Taylor Chuich, Value Institute, Christiana Care Health System, Newark, DE, USA, Email:

Editorial

In paediatric patients, healthcare-associated infections are a major cause of morbidity and mortality. Infection prevention is a specialty of anesthesiologists. Infection rates in surgical patients are reduced by hand hygiene and cleaning of the anaesthetic workspace. For the insertion and handling of central lines, arterial lines, and regional operations, standard protocols exist, which should be closely followed to avoid infection problems. Surgical site infections can be avoided by controlling temperature and administering medicines on time. In order to successfully execute infection prevention techniques, education, culture shift, employee participation, and effective change management are required.

Although dexmedetomidine has not been convincingly established to reduce overall morbidity and mortality and may be associated with greater drug costs, its other demonstrated effects provide benefits for postoperative cardiac surgery patients that other kinds of sedation cannot match. With a 25% chance of developing significant postoperative neurocognitive disorder (postoperative NCD or P-NCD) three months following surgery, older individuals undergoing cardiac surgery are at the highest risk. Morbidity, mortality, loss of independence, premature retirement, and increased healthcare expenses are all linked to P-NCD. This multicenter randomised trial compares the effectiveness of postoperative dexmedetomidine sedation to usual protocols in reducing the occurrence of serious P-NCD after heart surgery. CODEX will be the largest interventional trial with a primary endpoint of significant P-NCD.

We did a combined analysis of various data from similar research in order to enhance the sample size and improve the test efficiency from a statistical standpoint. We used a meta-analysis in this work to look at the sedative effect of dexmedetomidine on patients after heart surgery, in order to give a theoretical foundation and aid in the clinical treatment of cardiac illnesses. In cardiac surgeries, myocardial protection is essential, and multimodal approaches in the perioperative period are required to reduce and prevent increases in myocardial oxygen demand and consumption, which can lead to postoperative cardiac complications such as myocardial ischemia, dysfunction, and heart failure. In people undergoing cardiac surgery, dexmedetomidine has been demonstrated to reduce cardiac problems. Clinical investigations of dexmedetomidine on outcomes after paediatric heart surgery have produced mixed results.

Delirium is a type of acute brain malfunction that happens frequently in people who have had heart surgery and increases morbidity and death. It has been linked to risk factors such advanced age, drug usage, cardiopulmonary bypass, and hypothermia. Infusions of dexmedetomidine may have a neuroprotective effect. However, the impact of perioperative dexmedetomidine treatment on the occurrence of Postoperative Delirium (POD) in patients having cardiac or non-cardiac surgery is still debated. The goal of this trial was to see if intraoperative dexmedetomidine administration reduced the incidence of delirium in adult patients who had heart surgery. Many cardiovascular operations are rushed to extubation and require sedation for a brief period of time. Dexmedetomidine and propofol have extremely diverse modes of action and pharmacokinetic characteristics, making them both appealing sedatives in this patient population.

Although there has been an increase in the usage of dexmedetomidine in the Critical Care Unit (ICU), there are few studies that directly compare the two drugs in this context. From January to June 2011, we conducted a retrospective cohort analysis with patients hospitalised to the ICU after cardiovascular surgery. Adult patients who had coronary artery bypass surgery and/or cardiac valve surgery had a continuous infusion of dexmedetomidine or propofol for short-term sedation after the procedure. The major outcome measure was the amount of time spent on mechanical ventilation following surgery (in hours). The length of stay in the Intensive Care Unit (ICU), the length of stay in the hospital, the incidence of delirium, and the need for a second sedative drug were all secondary end goals [1-5].

References

1. Marra, Pasquale, Arianna Di Stadio, Vito Colacurcio and Alfonso Scarpa, et al. "Sedation with Intranasal Dexmedetomidine in the Pediatric Population for Auditory Brainstem Response Testing: Review of the Existing Literature." Healthcare 10 (2022): 287.

Google Scholar, Crossref, Indexed at

2. Rudikoff, Andrew G, David D. Tieu, Franklin M. Banzali and Carolyn V. Nguyen, et al. "Perioperative Acetaminophen and Dexmedetomidine Eliminate Post-Operative Opioid Requirement following Pediatric Tonsillectomy." J Clin Med 11 (2022): 561.

Google Scholar, Crossref, Indexed at

3. Allam Ayat A, Nermin E. Eleraky, Nadeen H. Diab and Mahmoud Elsabahy, et al. "Development of Sedative Dexmedetomidine Sublingual In Situ Gels: In Vitro and In Vivo Evaluations."Pharmaceutics14 (2022): 220.

Google Scholar, Crossref, Indexed at

4. Syrous, Nesjla Sofia, Terje Sundstrøm, Eirik Søfteland, and Ib Jammer. "Effects of Intraoperative Dexmedetomidine Infusion on Postoperative Pain after Craniotomy: A Narrative Review."Brain Sci11 (2021): 1636.

Google Scholar, Crossref, Indexed at

5. Yoo, Young Chul, Won Sik Jang, Ki Jun Kim and Jung Hwa Hong, et al. "Effect of Dexmedetomidine on Biochemical Recurrence in Patients after Robot-Assisted Laparoscopic Radical Prostatectomy: A Retrospective Study."J Pers Med 11 (2021): 912.

Google Scholar, Crossref, Indexed at