The brain protective effect of dexmedetomidine during surgery for paediatric patients with congenital heart disease

J Int Med Res. 2019 Apr;47(4):1677-1684. doi: 10.1177/0300060518821272.

Abstract

Objective: To study the brain protective effect of dexmedetomidine (DEX) during surgery in paediatric patients with congenital heart disease (CHD).

Methods: This randomized single-blind controlled study enrolled paediatric patients aged 0-3 years with CHD who underwent surgery and randomized them into two groups: one group received DEX and the control group received 0.9% NaCl during anaesthesia. Demographic data, heart rate (HR), mean arterial pressure (MAP) and central venous pressure (CVP) were recorded. Levels of neuron specific enolase (NES) and S-100β protein were determined using enzyme-linked immunosorbent assays.

Results: The study enrolled 80 paediatric patients with CHD. Compared with the control group, HR, MAP and CVP were significantly lower in the DEX group at all time-points except for T0. At all time-points except for T0, the levels of jugular venous oxygen saturation in the DEX group were significantly higher compared with the control group. At all time-points except for T0, the levels of arterial venous difference and cerebral extraction of oxygen were significantly lower in the DEX group compared with the control group. Levels of NES and S-100β protein in the DEX group were significantly lower compared with the control group at all time-points except for T0.

Conclusion: DEX treatment during surgery for CHD improved oxygen metabolism in brain tissues and reduced the levels of NES and S-100β protein.

Keywords: Dexmedetomidine; brain protective; congenital heart disease; surgery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Brain / drug effects*
  • Brain Injuries / prevention & control*
  • Child, Preschool
  • Dexmedetomidine / therapeutic use*
  • Female
  • Follow-Up Studies
  • Heart Defects, Congenital / drug therapy
  • Heart Defects, Congenital / surgery*
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Male
  • Monitoring, Intraoperative
  • Organ Sparing Treatments*
  • Prognosis
  • Protective Agents / therapeutic use*
  • Single-Blind Method

Substances

  • Hypnotics and Sedatives
  • Protective Agents
  • Dexmedetomidine