CARDIOVASCULAR
ENGINEERING
Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
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CARDIOVASCULAR
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Volume 2, 1997, No 2 |
Abstract:
Presently clonidine is the only a2-adrenoceptor agonist available
for clinical anesthesia. a2-Adrenoceptor agonists possess
sedative and antinociceptive actions. They reduce anesthetic
requirements and attenuate hemodynamic and endocrine reactions to
stressful stimuli. Because of these effects a2-adrenoceptor
agonists are increasingly used in anesthesia for patients
undergoing noncardiac surgery. However, many results indicate
that the use of a2-adrenoceptor agonists might also be benefitial
in patients undergoing cardiac surgery. Animal studies have shown
that the neurologic deficit and mortality after cerebral ischemia
is significantly improved after pretreatment with a2-adrenoceptor
agonists. Studies in coronary artery surgery patients proved that
the incidence of perioperative myocardial ischemia decreases due
to the attenuation of hemodynamic stress reactions and the
improvement of the myocardial oxygen supply-demand ratio. It
could be demonstrated that the impairment of renal function,
which is regularly seen after operations with extracorporal
circulation, is prevented after premedication with
a2-adrenoceptor agonists. The studies reviewed in this report
give rise to the presumption that the use of a2-adrenoceptor
agonists might be a tool to improve mortality and morbidity in
patients undergoing heart surgery. Because the incidence of
severe complications after cardiac surgery is small, studies
comprising large patient cohorts are necessary to confirm these
preliminary results.
Keywords:
cardiac surgery, cerebral ischemia, myocardial ischemia,
a2-adrenoceptor agonists
Address for Correspondence:
Reference:
(CVE. 1997; 2 (2): 83-96)
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