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  3. 10.Effect of Prophylactic Amiodarone Versus Dexmedetomidine on Reducing the Frequency of Postoperative Junctional Ectopic Tachycardia after Pediatric Open Heart Surgery
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10.Effect of Prophylactic Amiodarone Versus Dexmedetomidine on Reducing the Frequency of Postoperative Junctional Ectopic Tachycardia after Pediatric Open Heart Surgery

Talal Arshad1, Ram Chand3, Muhammad Asif Khan4, Rajab Ali Khokhar2, Veena Kumari1 and Abdul Sattar Shaikh1

ABSTRACT

Objective: To compare the effect of prophylactic amiodarone versus dexmedetomidine on reducing the frequency of post-surgical junctional ectopic tachycardia (JET) following pediatric open heart surgery.

Study Design: Randomized controlled trial study.

Place and Duration of Study: This study was conducted at the Pediatric Cardiology Intensive Care Unit (PCICU), National Institute of Cardiovascular Diseases, Karachi, Pakistan from May 2021 to April 2023.

Materials and Methods: Children of both genders aged between 1 to 12 years and planned to undergo cardiopulmonary bypass surgery were included. Children in amiodarone group (n=50) were given amiodarone at the time of induction of anaesthesia as 5-10 mcg per kg per minute (depending upon the hemodynamic) and continued for the next 48 hours. In the dexmedetomidine group (n=50), children were administered dexmedetomidine at the time of induction of anaesthesia as 0.2-0.5 mcg per kg per hour (depending upon the hemodynamics) and continued for the next 48 hours. The frequency of JET was noted.

Results: In a total of 100 children undergoing cardiopulmonary bypass surgery, 61 (61.0%) were boys while the mean age was 6.4±4.8 years. The mean cardiopulmonary bypass and aortic cross clamp time were 86.7±34.5 minutes and 45.9±24.1 minutes respectively. The most frequent types of CHDs were ventricular septal defect (VSD) and tetralogy of fallot (TOF) noted in 38 (38.0%) and 26 (26.0%) children respectively. Overall, frequency of JET was noted in 18 (18.0%) children. The frequency of JET was 5 (10.0%) children in amiodarone group versus 13 (26.0%) in the dexmedetomidine group (p=0.0373).

Conclusion: Post-surgical JET was found to be a common observation among children undergoing cardiopulmonary bypass surgery. Prophylactic amiodarone resulted in significantly less frequency of JET when compared to dexmedetomidine.

Key Words: Amiodaron, aortic clamp time, ventricular septal defect, dexmedetomidine, junctional ectopic tachycardia.

Citation of article: Arshad T, Chand R, Khan MA, Khokhar RA, Kumari V, Shaikh AS. Effect of Prophylactic Amiodarone Versus Dexmedetomidine on Reducing the Frequency of Postoperative Junctional Ectopic Tachycardia after Pediatric Open Heart Surgery. Med Forum 2023;34(6):40-43.