Efficacy and safety of low-dose dexmedetomidine in perioperative period of cyanotic congenital heart malformation

  AIM  To evaluate the efficacy and safety of low-dose dexmedetomidine for analgesia and sedation for infants and young children after cyanotic congenital heart malformation.

  METHODS  Included for this single-center prospective study were 151 children with cyanotic congenital heart malformations from July to December 2019, who were divided into Remifentanil+Midazolam treatment group (conventional group, n=81 cases) and Remifentanil+midazolam+dexmedetomidine treatment group (combined group, n=70 cases). The degree of analgesia and sedation, reintubation and the length of ICU stay were compared between the two groups.

  RESULTS  There was no significant difference in age, weight and grades of surgery between the two groups. Appropriate analgesia and sedation effects were achieved in both groups. In combined group, analgesia effect was better (P<0.05) and the dosages of opioids for remifentanil(46±7) μg /(kg·h) vs. (28±4) μg /(kg·h) and benzodiazepines(206±54) μg/ (kg·h) vs. (139±21) μg/(kg·h) for Midazolam were lower. The proportion of pain control incidence in combined group was lower (P<0.05). There was no significant difference in mechanical ventilation time and length of ICU stay between the two groups.

  CONCLUSION  Low-dose dexmedetomidine is safe and achieves good effect in analgesia and sedation after cyanotic congenital heart malformation in infants and young children. On the basis of achieving comfort effects, the dosages of opioids and benzodiazepines are also reduced.