Long QT Syndrome Unmasked by Dexmedetomidine: A Case Report

Burns, Kristin M.; Greene, Elizabeth A.

doi:10.1111/chd.12055

Cited by 12 publications

(9 citation statements)

References 17 publications

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“…The safety of dexmedetomidine has been evaluated in children and infants with critical disease and congenital heart disease and has been found to be safe, with a minimal side effect profile, 21,22 although in general it has been associated with bradycardia and hypotension and can trigger seizures and arrhythmias. 23,24 Our study has several limitations. First, our sample size is relatively small and originates from a single center, making generalizability difficult.…”

Section: Discussionmentioning

confidence: 94%

Use of Intranasal Dexmedetomidine as a Solo Sedative for MRI of Infants

Olgun

Ali

2018

Hospital Pediatrics

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Section: Discussionmentioning

confidence: 94%

Use of Intranasal Dexmedetomidine as a Solo Sedative for MRI of Infants

Olgun

Ali

2018

Hospital Pediatrics

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“…In the study by Byram et al ( 37 ), although the incidence of bradycardia (i e, HR decrease more than 20% of initial rate) was similar in both groups, it occurred in 4 patients in the Dex group versus 1 patient in the Mg group. Moreover, there are some case reports of cardiac arrest ( 41 - 43 ) following dexmedetomidine administration, which should be considered when choosing this drug as a hypotensive agent during operation.…”

Section: Discussionmentioning

confidence: 99%

Controlled Hypotension During Rhinoplasty: A Comparison of Dexmedetomidine with Magnesium Sulfate

et al. 2017

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ObjectiveThe current study aimed at comparing the efficacy of dexmedetomidine and magnesium sulfate to control blood pressure (BP) during rhinoplasty and the resultant effects on the quality of surgical field in terms of bleeding and visibility.MethodsThe current randomized, prospective, double-blind study was conducted on 60 patients aged 18 to 50 years classified as ASA (American Society of Anesthesiologists) physical status I who were candidates for rhinoplasty. Patients were randomly divided into 2 groups: (1) group Dex, received 1 µg/kg dexmedetomidine in 10 minutes before induction of anesthesia, followed by 0.4 - 0.6 µg/kg/hour during the maintenance of anesthesia, and (2) group Mg, received 40 mg/kg in 10 minutes before anesthesia induction followed by 10 - 15 mg/kg/hour during anesthesia maintenance. In both groups, the goal was to achieve a mean arterial pressure (MAP) of 60 - 70 mmHg. Hemodynamic variables, anesthetic, opioid, muscle relaxant requirements, and surgical field condition were recorded. Sedation score, time to reach modified Aldrete score ≥ 9, and adverse effects including nausea and vomiting (N&V) and shivering were recorded.ResultsControlled hypotension was achieved in both groups. There was no significant difference in MAP between the groups, but heart rate (HR) was significantly lower in the Dex group (P < 0.001), compared with that of the Mg group. Bleeding score was lower (P < 0.001) and surgeon’s satisfaction score was higher (P < 0.001) in the Dex group. More patients required fentanyl (P < 0.001) or nitroglycerin (P < 0.001) and the mean fentanyl (P = 0.005) or nitroglycerin (P < 0.001) required doses were higher in the Mg group. Patients in the Dex group required more frequent administration of cisatracurium (P = 0.004). Five patients in the Dex group versus no patients in the Mg group received atropine (P = 0.023). Ramsay sedation score and time to reach modified Aldrete score ≥ 9 were significantly higher in the Dex group (P < 0.001 and P < 0.001, respectively). The incidence rate of N&V and shivering were similar in both groups.ConclusionDexmedetomidine was more effective than magnesium to achieve controlled hypotension, and provide a favorable surgical field condition. However, dexmedetomidine also heightened the risk of induced bradycardia and prolonged sedation. These are 2 important points to consider when applying this drug as a hypotensive agent during operation.

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“…In an electrophysiology setting, a 1 μg·kg −1 dose of dexmedetomidine resulted in a small increase in corrected QT interval (QTc) (394 ± 9 vs 424 ± 9 ms) in children . A case report describes long QT syndrome being unmasked in a 22‐month‐old child after administration of a 1 μg·kg −1 bolus of dexmedetomidine . Also, the QTc was prolonged after a 1 μg·kg −1 bolus of dexmedetomidine while administering a 1 mg·kg −1 bolus of ketamine with a rapid return to baseline (326 ± 33 vs 360 ± 41 ms) .…”

Section: Introductionmentioning

confidence: 99%