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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

IBACACHE, Mauricio et al. Perioperative myocardical infaction in non-cardiac surgery and dexmedetomidine. Rev Chil Cardiol [online]. 2010, vol.29, n.1, pp.100-116. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602010000100011.

Cardiovascular disease is the leading cause of death In Chile and worldwide. Anesthesiologists and surgeons often face more elderly surgical patents with cardiovascular disease. The incidence of myocardial Ischemia in patents at high risk, undergoing non-cardiac surgery is about 40% during the perioperative period. The incidence of myocardial Infarction and death in non-cardiac surgery is between 1 and 5%. There is a close relationship between perioperative Ischemic events and increased cardiovascular morbidity and mortality Therefore, therapeutic approaches have been developed to reduce the Incidence of perioperative Ischemia and lessen the damage associated with it. The proper Identification of patients at risk, optimizing the medical treatment of associated diseases and the use of cardioprotective drugs during the perioperative period have shown to decrease the Incidence of cardiac complications. The á2-adrenergic agonist dexmedetomidine is commonly used in anesthesia. The evidence suggests that possesses cardioprotective properties that could benefit surgical patients at high cardiovascular risk. The cardioprotection conferred by dexmedetomidine would be mediated by modulation of the autonomic nervous system. The decrease in heart rate and blood pressure observed during its use could avoid the Imbalance between supply and myocardial oxygen demand and lessen the stress on unstable athermanous plaques. So far it is unknown whether dexmedetomidine produces cardiac preconditioning by activating cardioprotective-signaling pathways. Faced with the current worldwide epidemiologic situation, It would be Important to study the cardioprotective capacity of drugs frequently used in anesthesia and the mechanisms Involved In that protection. It would be interesting to achieve that definition regarding the perioperative use of dexmedetomidine.

Keywords : perioperative ischemia; á2 - adrenergic agonist; cardioprotection; dexmedetomidine; Myocardial infarction; beta-adrenergic receptor.

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