METHODS
Our protocol was approved by the local Research and Ethics Committee on
Health Research No. 3502 of the General Hospital “Gaudencio González
Garza” of the La Raza, National Medical Center (IMSS), registered in
BioMed Central ISRCTN 17397629 , and the study was conducted in
accordance with the principles laid out in the Declaration of Helsinki,
2000. Written informed consent was obtained from the patients. This
clinical trial was conducted following the guidelines of the CONSORT
Statement (14 ).
Study design
We conducted a prospective, randomized and controlled clinical trial in
20 adult patients of the Cardiothoracic surgery service.
Study Participants
Inclusion criteria: Patients with stable coronary artery disease
undergoing elective off-pump CABG. In physical state ASA II and III,
according to risk classification by the American Society of
Anesthesiology (15 ). Patients older than 18 years of age, with
renal function were included: creatinine <1,4 mg / dL and left
ventricular ejection fraction (LVEF) ≥ 40%, Cardiac Index ≤2.5 L,
evaluated by echocardiogram.
Exclusion criteria: Patients with hepatic or renal impairment, patients
with hemodynamic instability (cardiogenic shock), patients requiring
coronary revascularization with extracorporeal circulation and
candidates for cardiac reoperation.
Interventions
A controlled clinical study in patients undergoing elective off-pump
CABG, under standardized general anesthesia. Randomly received infusions
of Esmolol 0.5 mg /kg/1 min (Group E, n=10) or Dexmedetomidine 0.5
mcg/kg/hr. (Group DEX, n=10). Through administration withFresenius-Kabi® volumetric infusers. The monitored parameters
were: invasive blood pressure, oxygen saturation, electrocardiogram,
bispectral index for the depth of anesthesia, and central venous
catheter. The hemodynamic data outcome variables of this study are heart
rate and invasive blood pressure which were analyzed at different times:
t1) baseline,
t2) sternotomy,
t3) time of coronary anastomosis,
t4) sternal closure,
We have compared the analysis of the hemodynamic profile, narcotics and
muscle relaxant rate; arterial blood gas and hemogram parameters were
recorded during surgery. All patients underwent balanced general
anesthesia with desflurane and invasive monitoring for the measurement
of hemodynamic parameters. At the end of the surgical procedure, the
patients were transferred to the Intensive Care Unit (ICU).