Dexmedetomidine Does Not Reduce Atrial Fibrillation After Lung Cancer Surgery

• Published in: Journal of cardiothoracic and vascular anesthesia Vol. 29; no. 2; pp. 396 - 401
• Main Authors: Ai, Di, MD, PhD, Xu, Gang, MD, Feng, Lei, MS, Yu, Jun, MS, Banchs, Jose, MD, Vaporciyan, Ara A., MD, Cata, Juan P., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2015
• Subjects: Adrenergic alpha-2 Receptor Agonists - therapeutic use; Aged; Anesthesia & Perioperative Care; atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - drug therapy; Atrial Fibrillation - etiology; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - surgery; Critical Care; dexmedetomidine; Dexmedetomidine - therapeutic use; Female; Humans; Intraoperative Care - methods; lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - surgery; Male; Middle Aged; noncardiac surgery; postoperative; Postoperative Complications - diagnosis; Postoperative Complications - drug therapy; Postoperative Complications - etiology; Pulmonary Surgical Procedures - adverse effects; Retrospective Studies; Treatment Outcome; postoperative; lung cancer; dexmedetomidine; atrial fibrillation; noncardiac surgery
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2014.05.013

Objective To evaluate whether the use of intraoperative dexmedetomidine (DEX) during lung cancer surgery may reduce the incidence of postoperative atrial fibrillation (POAF). Design A retrospective study. Setting Academic hospital. Participants Seven hundred three adult patients with non-small-cell lung cancer. Measurements and Main Results Patients younger than 18 years of age with a history of atrial fibrillation were excluded. Episodes of atrial fibrillation were identified from electronic medical records and consisted of cardiology consultations, electrocardiogram records, and use of anti-arrhythmic medications within the postoperative admission time. The Wilcoxon rank sum test was used to evaluate the difference in a continuous variable between patient groups. Fisher’s exact test or the chi-square test was used to evaluate the association between 2 categorical variables. Logistic regression models were used for multivariate analysis. Overall POAF incidence was 136 of 703 (19.35%), with a mean onset of 3.01±2.03 days after surgery. Among patients, 204 (29.02%) received DEX intraoperatively. Male gender and age were strong predictors of POAF. POAF incidence was comparable between patients who were (n = 93, 21.1%) and were not (n = 43, 18.6%) treated with DEX (p = 0.46). The mean onset time of arrhythmia was similar in both groups (DEX users: 2.93±2.49 days; non-DEX users: 3.05±1.79 days; p = 0.146). Conclusion These results were similar to those published elsewhere on POAF incidence and risk factors. This study could not confirm the hypothesis that the intraoperative use of DEX is associated with a reduced rate of POAF after thoracic surgery for lung cancer.