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).