Dexmedetomidine does not reduce atrial fibrillation after lung cancer surgery

J Cardiothorac Vasc Anesth. 2015 Apr;29(2):396-401. doi: 10.1053/j.jvca.2014.05.013. Epub 2014 Oct 24.

Abstract

Objective: To evaluate whether the use of intraoperative dexmedetomidine (DEX) during lung cancer surgery may reduce the incidence of postoperative atrial fibrillation (POAF).

Design: A retrospective study.

Setting: Academic hospital.

Participants: Seven hundred three adult patients with non-small-cell lung cancer.

Measurements and main results: Patients younger than 18 years of age with a history of atrial fibrillation were excluded. Episodes of atrial fibrillation were identified from electronic medical records and consisted of cardiology consultations, electrocardiogram records, and use of anti-arrhythmic medications within the postoperative admission time. The Wilcoxon rank sum test was used to evaluate the difference in a continuous variable between patient groups. Fisher's exact test or the chi-square test was used to evaluate the association between 2 categorical variables. Logistic regression models were used for multivariate analysis. Overall POAF incidence was 136 of 703 (19.35%), with a mean onset of 3.01±2.03 days after surgery. Among patients, 204 (29.02%) received DEX intraoperatively. Male gender and age were strong predictors of POAF. POAF incidence was comparable between patients who were (n=93, 21.1%) and were not (n=43, 18.6%) treated with DEX (p=0.46). The mean onset time of arrhythmia was similar in both groups (DEX users: 2.93±2.49 days; non-DEX users: 3.05±1.79 days; p=0.146).

Conclusion: These results were similar to those published elsewhere on POAF incidence and risk factors. This study could not confirm the hypothesis that the intraoperative use of DEX is associated with a reduced rate of POAF after thoracic surgery for lung cancer.

Keywords: atrial fibrillation; dexmedetomidine; lung cancer; noncardiac surgery; postoperative.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic alpha-2 Receptor Agonists / therapeutic use
  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / etiology
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Dexmedetomidine / therapeutic use*
  • Female
  • Humans
  • Intraoperative Care / methods
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / drug therapy*
  • Postoperative Complications / etiology
  • Pulmonary Surgical Procedures / adverse effects*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Adrenergic alpha-2 Receptor Agonists
  • Dexmedetomidine