Effect of dexmedetomidine on stented artery diameter during elective endovascular myocardial revascularization

Abstract

Introduction. Dexmedetomidine (a highly selective α2-adrenergic agonist) is used for analgosedation in various interventions. Some studies have noted that a loading dose of dexmedetomidine 1.0 μg/kg/15 minutes can lead to a decrease in the diameter of the coronary arteries in both healthy volunteers and patients with coronary heart disease (CHD). The aim of the study was to evaluate the effect of monoanesthesia with dexmedetomidine on the diameter of the stented artery (proximal and distal to the site of stenosis) during elective endovascular stenting of the coronary arteries. Materials and methods. A quasi-experimental study "before and after" was carried out. The study included 22 patients from September 2021 to January 2022. A comparison of 27 indicators was carried out, since 5 patients underwent simultaneous stenting of 2 coronary arteries. Results. The diameter of the proximal section of the stented artery before the loading dose of dexmedetomidine was 2.9 mm [2.5–3.4]; after loading dose – 3.0 mm [2.5–3.4] (p = 0.6). The initial diameter of the distal segment of the coronary artery was 2.2 mm [1.7–2.4], while after a loading dose of dexmedetomidine it was 2.2 mm [2.0–2.5] (p = 0.001). Discussion. In this study, there was no change in the proximal segment of the coronary artery when using a loading dose of dexmedetomidine 0.5 mcg/kg/10 minutes. Whereas an increase in the diameter of the distal coronary arteries has been reported with the above loading dose of dexmedetomidine. Conclusion. Despite a number of limitations of this study (factors affecting the diameter of the coronary arteries that were not taken into account), with a certain degree of optimism, one can speak of a smaller effect of a loading dose of dexmedetomidine 0.5 μg/kg/10 minutes on the diameter of the lumen of the coronary arteries.