Dexmedetomidine in anesthesia for planned endovascular myocardial revascularization

Abstract

Introduction. Endovascular stenting of coronary arteries is an effective, minimally invasive and rapidly developing method of coronary heart disease (CHD) treatment. The question regarding the choice of a drug for adequate and safe monitoring sedation in patients during this type of surgical procedures remains open. The aim of the study was to discuss a clinical case of dexmedetomidine in elective endovascular stenting of coronary arteries. Materials and methods. A clinical case of dexmedetomidine in anesthesia during elective stenting of the right coronary artery and its analgesic effect in the development of right coronary artery (RCA) dissection are described. Results. Patient S., 72 years old, after planned endovascular stenting of the right coronary artery with 3 stents at the time of his admission to the intensive care unit (ICU) had no angina pains and sternal discomfort. The patient was transferred to the specialized department 8 hours after stenting in a stable condition. Serum cardiospecific troponin T level was less than 0.2 ng/ml 6 hours after RCA stenting. No negative dynamics was described on the control ECG after surgical intervention. Discussion. Dexmedetomidine has a proven analgesic effect due to its direct effect on the peripheral nervous system. Conclusion. The use of dexmedetomidine has its place in periprocedural sedation in patients with coronary heart disease during planned endovascular coronary artery stenting, including patients with significant (over 90%) and extended coronary artery stenoses. The clinical use of dexmedetomidine in elective minimally invasive coronary interventions requires closer attention and study.