Evaluation of the Safety and Efficacy of Dexmedetomidine as an Anesthetic Adjuvant in Coronary Artery Bypass Grafting Surgeries

Abstract

oronary artery bypass grafting surgery (CABG) still is a main treatment procedure of coronary artery diseases up till now, unfortunately comes with a considerable high rate of complications. The 30-day mortality is about 1.2% in the on-pump coronary artery bypass grafting (CABG) surgery, and in elderly patients (>65 years) mortality is 8.1% at 1 year (Shahian et al., 2012). These major complications include postoperative delirium, infection, acute renal failure (ARF), and major adverse cardio-cerebral events that include permanent or transient stroke, coma, perioperative myocardial infarction (MI), heart block and cardiac arrest. More than 50% of all perioperative complications are related to cardiovascular events. These complications are translated into increased mortality and prolonged hospital stays with estimated costs exceeding 20 billion dollars annually (Fuhai et al., 2016). Although there are many contributing factors to these adverse events, surgical stress response is one of the most important factors in the pathogenesis of these complications (Brown et al., 2008). Stress response to surgery is a major neuroendocrine and cytokine response to surgical trauma, characterized by increase in catecholamine and steroid hormones, with predictable