Introduction: Our aim was to compare effectiveness of esmolol and dexmedetomidine in the treatment of increased hemodynamic response during off?pump coronary artery bypass grafting. (OPCAB).
Methods: Twenty adult patients undergoing elective OPCAB were recruited for this prospective study. Inclusion criteria were elective OPCAB and age 18–75 years. Patients were excluded preoperatively if they gave a history of severely impaired cardiac function, ejection fraction less than 30%, history suggestive of sensitivity to drugs used during the study. Those requiring emergency surgery were also excluded. Receiving standardized etomidate– vecuronium- fentanyl-based anaesthesia. Randomly received infusions of esmolol 0.5 mg /kg/1 min (Group E, n=10) or Dexmedetomidine 0.5 mcg/kg/hr.(Group DEX, n=10). The infusion was started after sternotomy. The goal was to maintain bradycardia (?50 bpm) and mean arterial pressure (MAP) ?60-75mmHg.
Results: After drug, HR reductions were significant during the intraoperative period in group Dexmedetomidine. Hemodynamic Variables: HR, MAP, Svo2 .70% and a serum lactate concentration ?2.0 mmol/L, time of surgery and narcotic consumption, values of the two groups during the study. In the DEX group (HR) was significantly lower than the baseline in all measurement times.
Conclusions: Although esmolol and dexmedetotimidine attenuated hemodynamic response during coronary artery bypass grafting period, dexmedetotimidine was more effective in hemodynamic stabilization.