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Volume 9- No. 4 2021

Educated Hand Publishing LLC 
“The Science Behind the Art” 
Volume 9 - No.4 2021 

 Anesthesia eJournal - Online
ISSN 2333-2611

Page 7

Dexmedetomidine as an Anesthetic Adjunct in Off-Pump Coronary Artery Bypass Grafting: 
A Case Report
Dean Vanek, BSN, RN 

Affiliation:
 Texas Christian University

Grant/Financial Support: 
None

Biographical data:  
Dean Vanek is a Registered Nurse who is currently enrolled in Texas Christian University’s Nurse Anesthesia program. 

KEYWORDS:  Precedexâ, dexmedetomidine, off-pump coronary artery bypass grafting, alpha-2 agonist, cardiac surgery

Abstract
This case report describes the implementation of a dexmedetomidine (Precedexâ) infusion in a patient undergoing off-
pump coronary artery bypass grafting (OPCABG). The focus of this case report is to analyze the impact dexmedetomi-
dine has on perioperative opioid consumption, postoperative recovery, and hemodynamic effects that result. The addition 
of a dexmedetomidine infusion to the anesthetic plan of care in patients undergoing OPCABG is supported by current 
literature. Dexmedetomidine has many advantageous effects including analgesia, improvement in hemodynamic stability, 
and offers cardiac protection.1 The end result may lead to decreased narcotic requirements which may enable earlier 
extubation times and an overall decreased length of stay in the ICU.1,2,3 Intraoperative hemodynamic instability result-
ing from fluctuations in plasma levels of norepinephrine and epinephrine due to surgical stimulation are attenuated by 
dexmedetomidine due to the reduction in sympathetic output as a result of alpha-2 agonism.4 Heart rate, mean arterial 
pressure, and systemic vascular resistance will be lower intraoperatively and postoperatively as a result.4,5 Incidence rates 
of arrythmias occurring perioperatively such as atrial fibrillation, premature atrial contractions, premature ventricular 
contractions, and heart blocks are decreased with the use of dexmedetomidine.4,6 Dexmedetomidine is shown to be a 
safe and useful anesthetic adjunct in patients undergoing OPCABG. 

AEJ