Comparison of the Effects of Dexmedetomidine and Propofol on Hemodynamics and Oxygen Balance in Children with Complex Congenital Heart Disease Undergoing Cardiac Surgery.

Objective: The aim of this study was to compare the effects of anesthesia by dexmedetomidine and propofol on the hemodynamics and oxygen balance in children with complex congenital heart disease who were undergoing cardiac surgery.

Methods: Fifty-seven children were randomized to receive either a continuous infusion of propofol (6-8 mg/kg/h) or dexmedetomidine (0.5-0.7 μg/kg/h) after anesthesia induction. Hemodynamic data were recorded. Oxygen balance parameters were assessed at baseline after midazolam sedation, before and immediately after skin incisions were made, after sternotomy, 5 minutes after protamine administration, and at the end of surgery.

Results: Compared with the dexmedetomidine group, the propofol group exhibited decreases in blood pressure, cardiac output, and cardiac index before skin incision (P < .05) and increases in blood pressure, heart rate, cardiac output, and cardiac index after sternotomy (P < .01). However, very similar trends in oxygen dynamics were obtained in both groups (P > .05), and the cardiac index was not correlated with total oxygen consumption (r = -0.109, P = .066) or the oxygen extraction ratio (r = -0.107, P = .072).

Conclusions: Dexmedetomidine infusion may be superior to propofol anesthesia in children with complex congenital heart disease who are undergoing cardiopulmonary bypass because dexmedetomidine was associated with less variability in heart rate or blood pressure during surgery. However, the oxygen balance was similar when either agent was used.