Intraoperative use of clonidine and dexmedetomidine for prevention of early postoperative neurocognitive disorders after coronary artery bypass surgery

Balandina E.V.; Volchkov V.A.; Boyarkin A.A.; Nefedov A.V.; Kovalev S.V.

doi:https://doi.org/10.17116/anaesthesiology202004142

Balandina E.V.

St. Petersburg State University;
St. Petersburg City Multi-field Hospital No. 2

Volchkov V.A.

St. Petersburg State University;
St. Petersburg City Multi-field Hospital No. 2

ORCID: 0000-0002-5664-7386

Boyarkin A.A.

St. Petersburg State University;
St. Petersburg City Multi-field Hospital No. 2

ORCID: 0000-0002-5910-6200

Nefedov A.V.

St. Petersburg City Multi-field Hospital No. 2

Kovalev S.V.

St. Petersburg City Multi-field Hospital No. 2

Intraoperative use of clonidine and dexmedetomidine for prevention of early postoperative neurocognitive disorders after coronary artery bypass surgery

Authors:

Balandina E.V., Volchkov V.A., Boyarkin A.A., Nefedov A.V., Kovalev S.V.

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Journal: Russian Journal of Anesthesiology and Reanimatology. 2020;(4): 42‑47

DOI: 10.17116/anaesthesiology202004142

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To cite this article:

Balandina EV, Volchkov VA, Boyarkin AA, Nefedov AV, Kovalev SV. Intraoperative use of clonidine and dexmedetomidine for prevention of early postoperative neurocognitive disorders after coronary artery bypass surgery. Russian Journal of Anesthesiology and Reanimatology. 2020;(4):42‑47. (In Russ.)
https://doi.org/10.17116/anaesthesiology202004142

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OBJECTIVE

To evaluate an effectiveness of intraoperative use of dexmedetomidine and clonidine for prevention of early postoperative neurocognitive disorders after coronary artery bypass grafting.

MATERIAL AND METHODS

A prospective study included 200 patients who underwent elective coronary artery bypass grafting under general combined anesthesia for the period from 2018 to 2019. Patients were randomized into 3 groups: group 1 (control) — 100 patients, group 2 (clonidine) — 50 patients, and group 3 (dexmedetomidine) — 50 patients. Inclusion criteria were elective coronary artery bypass grafting, age 40—80 years, LV ejection fraction (Simpson’s method) >50%, absence of dementia and mental illness. Clonidine and dexmedetomidine were injected after anesthesia induction and for 2 hours in early postoperative period. PND were evaluated using NuDESC (Nursing delirium screening scale) and SAGE (Self-Administrated Gerocognitive Exam) scales.

RESULTS

In the control group, delirium developed in 19% of patients, in clonidine group — 6%, dexmedetomidine group — 4% of patients (p=0,010 compared to the control group).

CONCLUSION

Intraoperative use of clonidine and dexmedetomidine reduced the incidence of delirium in postoperative period.

Keywords:

postoperative neurocognitive dysfunction

alpha-2 adrenergic receptor agonists

dexmedetomidine

clonidine

coronary artery bypass grafting

Authors:

Balandina E.V.

St. Petersburg State University;
St. Petersburg City Multi-field Hospital No. 2

Volchkov V.A.

St. Petersburg State University;
St. Petersburg City Multi-field Hospital No. 2

ORCID: 0000-0002-5664-7386

Boyarkin A.A.

St. Petersburg State University;
St. Petersburg City Multi-field Hospital No. 2

ORCID: 0000-0002-5910-6200

Nefedov A.V.

St. Petersburg City Multi-field Hospital No. 2

Kovalev S.V.

St. Petersburg City Multi-field Hospital No. 2

Received:

31.03.2020

Accepted:

22.04.2020

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