Preincision Initiation of Dexmedetomidine Maximally Reduces the Risk of Junctional Ectopic Tachycardia in Children Undergoing Ventricular Septal Defect Repairs

Efficacy of prophylactic dexmedetomidine in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery patients: A systematic review and meta‐analysis

“…Two studies reported use of antiarrhythmic drugs . In both these studies, the use of antiarrhythmic agents was higher in the control group compared to the dexmedetomidine group.…”

“…Although the JET incidence is lower in the treated group, the degree of the decrease seemed to be the least pronounced . On the other hand, the study by Gautam et al took a step further and compared the incidence of JET among patients who received dexmedetomidine during preoperatively and continued through the postoperative period, patients who received dexmedetomidine only intraoperatively, and patients who received dexmedetomidine only during the postoperative period. The findings lead to a conclusion that only administering preoperatively and continued through the immediate postoperative period showed a significant benefit of reducing JET incidence.…”

“…Similar to dosing variation, the duration of dexmedetomidine infusion was variable among studies. In particular, whereas dexmedetomidine infusion was continued for at least 24 hours in 5 studies, the infusion was only continued for 8‐12 hr in the other 2 studies (by Rajput et al and by Gautam et al) . As postoperative JET occurs frequently up to 48 hours in the immediate postoperative period, the shorter duration of infusion may not be sufficiently long enough.…”

Efficacy of dexmedetomidine in prevention of junctional ectopic tachycardia and acute kidney injury after pediatric cardiac surgery: A meta‐analysis

“…Five studies were excluded for several reasons including the lack of primary outcomes, evaluation of noncardiac surgery, and the lack of a control group. Eventually, 9 studies comprising 4 RCTs, 1 quasi‐RCT and 4 observational cohort studies ultimately met our selection criteria and were included in the quantitative synthesis. Among them, 7 studies were pooled for JET, and 2 studies were pooled for AKI .…”

“…Eventually, 9 studies comprising 4 RCTs, 13,14,16,20 1 quasi-RCT 15 and 4 observational cohort studies [21][22][23][24] ultimately met our selection criteria and were included in the quantitative synthesis. Among them, 7 studies were pooled for JET, [13][14][15][16]21,22,24 and 2 studies were pooled for AKI. 20,23 A flow diagram for the meta-analysis is presented in Sensitivity analysis excluding each included study one by one did not significantly alter the effect estimate of JET and mortality.…”