Influence of Dexmedetomidine on Myocardial Injury in Patients with Simultaneous Pancreas-Kidney Transplantation.Dong, A., et al.
Evidence-Based Complementary & Alternative Medicine: eCAM 2022; 2022: 7196449.
This study aimed to investigate the effect of dexmedetomidine (Dex) on myocardial injury in simultaneous pancreas-kidney transplant recipients.
Participants were randomised to either the dexmedetomidine (Dex) group or the saline (control) group.
94 simultaneous pancreas-kidney transplant recipients.
The outcomes of interest were changes in group haemodynamic variables, differences in inflammatory factors and myocardial injury biomarkers between the Dex and the control group, and intraoperative adverse cardiovascular events.
In this RCT, patients undergoing simultaneous kidney pancreas transplant were randomised to receive an infusion of dexmedetomidine or saline. Patients were blinded to their group allocation. There were no significant differences in haemodynamic measures intra-operatively. TNF-alpha and IL-6 in the serum was significantly higher in the control group than the study group from 30 minutes into surgery until 24 hours after. Immediately after surgery cardiac troponin was significantly higher in the control group than the study group. The rise in CK-MB in both groups also fell away quicker in the study group after surgery. There was no statistically significant difference in intra-operative cardiac events or ECG changes. The study shows an ischaemia- reperfusion event after pancreas and kidney reperfusion, with possible cardiac effects. There is no power calculation and it is not clear what the primary outcome was, so the study may be underpowered.
Per protocol analysis