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| Retrospective study on heart rate control and early prognosis of dexmedetomidine combined with beta-blocker in patients with acute type A aortic dissection |
| Chen Sheng-long, Yang Ren-qiang, Han Yong-li, Liu Xin-qiang, Wen Miao-yun, Huang Lin-qiang, Zeng Hong-ke |
| Intensive Care Unit, Guangdong General Hospital (Guangdong Academy of Medical Science), Guangzhou 510080, China |
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Abstract Objective To investigate the effect of dexmedetomidine（Dex）combined with beta-blocker on heart rate(HR) control and early prognosis in patients with acute aortic dissection. Methods A retrospective analysis included 121 patients with acute A type aortic dissection from February 2017 to April 2018. All the patients were routinely used for analgesic and antihypertensive drugs, and beta-blockers (esmolol compined with oral metoprolol) were used to control HR. The patients were randomly divided into non-dexmedetomidine (group Non-Dex,n=52) and dexmedetomidine (group Dex, n=69) according to whether applied for dexmedetomidine or not. The rate of HR and SBP, the fluctuation of HR and SBP, the amount of esmolol use, the incidence of acute pulmonary edema and the early rupture of aortic dissection (within 3 days of admission) were observed. Results Compared with group Non-Dex, the HR of group Dex began to decrease at 1 h after intervention (P<0.05), and the control rate of 3 and 6 h in group Dex was significantly higher than that in group Non-Dex (53.22% vs. 33.45%, 78.24% vs. 56.35%, P<0.05), and the fluctuation of HR was smaller in the Dex group(P<0.05). The amount of esmolol use was significantly reduced ［(3569.34±1201.14)mg vs. (6812.12±1801.04) mg, P<0.05］; There was no significant difference in control rate of SBP between two groups, 73.21% and 70.65% respectively, however the SBP fluctuation in the Dex group was less than that in the Non-Dex group (P<0.05). The incidence of acute pulmonary edema and early rupture of aortic dissection within 3 d of admission in the Dex group was 10.31% and 11.91% respectively, which were significantly lower than those in group Non-Dex 21.23% and 23.36% respectively (P<0.05). Conclusion Dexmedetomidine is useful to control HR more quickly and effectively, reduce the dosage of beta-blocker, and make the control of SBP more stable and improve the early survival rate in patients with acute A type aortic dissection.
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Corresponding Authors:
Zeng Hong-ke, E-mail:zenghongke@vip.163.com
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