Article thumbnail

Effects of Dexmedetomidine-Fentanyl Infusion on Blood Pressure and Heart Rate during Cardiac Surgery in Children

By Jyrson Guilherme Klamt, Walter Villela de Andrade Vicente, Luis Vicente Garcia and Cesar Augusto Ferreira


Background. The purpose of this study was to access the effects of dexmedetomidine-fentanyl infusion on blood pressure (BP) and heart rate (HR) before surgical stimulation, on their changes to skin incision, and on isoflurane requirement during cardiac surgery in children. Methods. This study had a prospective, randomized, and open-label design. Thirty-two children aged 1 month to 10 years undergoing surgery for repair congenital heart disease (CHD) with CPB were randomly allocated into two groups: group MDZ received midazolam 0.2 mg·kg−1·h−1 and group DEX received dexmedetomidine 1 μg·kg−1·h−1 during the first hour followed by half of these rates of infusions thereafter. Both group received fentanyl 10 μg·kg−1, midazolam 0.2 mg·kg−1 and vecuronium 0.2 mg·kg−1 for induction. These same doses of fentanyl and vecuronium were infused during the first hour then reduced to half. The infusions started after induction and maintained until the end of surgery. Isoflurane was given briefly to control hyperdynamic response to skin incision and sternotomy. Results. In both groups, systolic blood pressure (sBP) and heart rate (HR) decreased significantly after one hour of infusion of the anesthetic solutions, but there were significantly less increase in diastolic blood pressure, sBP, and HR, and less patients required isoflurane supplementation to skin incision in the patients of the DEX group. Discussion. Dexmedetomidine infusion without a bolus appears to be an effective adjunct to fentanyl anesthesia in control of hemodynamic responses to surgery for repair of CHD in children

Topics: Research Article
Publisher: Hindawi Publishing Corporation
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (2006). A .K o r o g l u ,H .T e k s a n ,O .S a g i r ,A .Y u c e l ,H .I .T o p r a k ,a n d
  2. (2005). A .K o r o g l u ,S .D e m i r b i l e k ,H .T e k s a n ,O .S a g i r
  3. (2006). A .M .M u k h t a r ,E .M .O b a y a h ,a n dA .M .H a s s o n a ,“ T h eu s e of dexmedetomidine in pediatric cardiac surgery,” Anesthesia and Analgesia,
  4. (2005). Anomalies of the aortic arch and valve,” in Pediatric Cardiac Anesthesia,C .L .L a k ea n dP
  5. (2001). Cardiovascular effects of sevofluorane, isofluorane, halothane, and fentanylmidazolan in children with congenital heart disease,”
  6. (2003). Development of bradycardia during sedation with dexmedetomidine in an infant concurrently receiving digoxin,”
  7. (2007). Dexmedetomidine as a total intravenous anesthetic agent in infants,”
  8. (2007). Dexmedetomidine as a total intravenous anesthetic in infants,”
  9. (2004). Dexmedetomidine infusion without loading dose in surgical patients requiring mechanical ventilation: haemodynamic
  10. (2006). Dexmedetomidine-ketamine and propofol-ketamine combinations for anesthesia in spontaneously breathing pediatric patients undergoing cardiac catheterization,”
  11. (2007). Dexmedetomidine: an updated review,”
  12. (2005). H a m m e r ,B .M .P h i l i p ,A .R .S c h r o e d e r
  13. (2007). H.M.Munro,C.F.Tirotta,D.E.Felixetal.,“Initialexperience with dexmedetomidine for diagnostic and interventional cardiac catheterization in children,”
  14. (2007). Hemodynamic and respiratory changes following dexmedetomidine administration during general anesthesia: sevoflurane vs desflurane,”
  15. (2008). High dose dexmedetomidine as the sole sedative for pediatric
  16. (1994). J.Lerman,N.Sikich,S.Kleinman,andS.Yentis,“Thepharmacology of sevoflurane in infants and children,”
  17. (2008). Pro: dexmedetomidine should be used for infants and children undergoing cardiac surgery,”
  18. (2002). Pulmonaryto-systemic blood flow ratio effects of sevoflurane, isoflurane,
  19. (2004). Sedation during mechanical ventilation in infants and children: dexmedetomidine versus midazolam,”
  20. (2001). Stress response in infants undergoing cardiac surgery: a randomized study of fentanyl bolus, fentanyl infusion, and fentanyl-midazolam infusion,”AnesthesiaandAnalgesia,vol.92,no.4,pp.882–890,
  21. (2008). The effects of dexmedetomidine on cardiac electrophysiology
  22. (2004). The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery,” Anesthesia and Analgesia,
  23. (2006). z k o s e ,F .S .D e m i r ,K .P a m p a l ,a n dS .Y a r d i m ,“ H e m o -dynamic and anesthetic advantages of dexmedetomidine, an α2-agonist, for surgery in prone position,”