الفهرس 
STRESS RESPONSEOnly 14 pages are availabe for public view
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Abstract
Background: Coronary artery bypass grafting surgeries (CABG) still the main procedure for treating coronary artery diseases, unfortunately comes with high rate of complications. These complications are multifactorial but the main cause is surgical stress response. Dexmedetomidine is an alpha 2 receptor blocker which has many biological effects that may help in attenuation of stress response and decrease adverse effects accompany CABG operations.
Objective: The aim of this work is to evaluate the potential benefits and risks of intraoperative usage of dexmedetomidine as an adjuvant to anaesthesia in coronary artery bypass grafting surgeries.
Patients and methods: Two groups of patients (group D and group P) were included in this study who needed CABG operation , 25 patient in each group who were selected randomly, As regard study group D, dexmedetomidine was administered as loading dose before anesthesia induction then infusion of maintenance dose all through the operation steps including cardiopulmonary bypass time till start of skin closure. In contrast, control group P was administered placebo in the same manner as dexmedetomidine. Hemodynamics, total opioid dosage needed, vaso-active and vaso-dilator medications usage, recovery rhythm, DC shock usage, cardiac complications up to 48 hours postoperative, and cortisol level at different stressful events during surgery was measured as a marker to stress response.
Results: No significant differences between two groups as regard demographic data. There were high significant differences as regard hemodynamics during stressful events to be more controlled in study group D. Opioid dosage needed to over come surgical stress was significantly lower in study group D as compared to control group P. more vaso-active medications needed to stabilize hemodynamics in study group D, while, more vaso-dilators needed in control group P. Arrhythmic recovery rhythm and need of DC shock were much lower in study group D. There were no significant differences as regard postoperative cardiac complications between the two groups. As regard cortisol level, it was significantly lower in study group D in contrast to control group P.
Conclusion: Usage of dexmedetomidine as an adjuvant to anesthesia in coronary artery bypass grafting surgeries is safe, very effective in attenuation of surgical induced stress response with its accompanied adverse effects, and a step up in fast track cardiac surgeries.