Evidence-Based Practice Guidelines for Perioperative Use of Dexmedetomidine in Pediatric Congenital Cardiac Surgery

Tachyarrhythmias are common postoperatively in the congenital cardiac surgery population. About 1% of the population is born with congenital heart disease (CHD), with 50% of patients undergoing surgery for CHD experiencing arrhythmias. Complications can arise from postoperative arrhythmias, including hemodynamic instability and myocardial depression, having catastrophic health repercussions. Despite the high prevalence and complications, there is no standard practice for postoperative tachyarrhythmia prevention in the chosen population, and prevention is at the provider's discretion. However, literature exploring the effects of dexmedetomidine notes promising results for using the drug for postoperative tachyarrhythmia prevention. The project aims to address the lack of evidence-based guidelines for tachyarrhythmia prevention in CHD cardiac surgery patients by implementing evidence-based practice guidelines for the intraoperative use of dexmedetomidine. The project utilizes quantitative data to evaluate and assess the effectiveness of the guideline in a level one pediatric trauma center. Following a review of literature, data collection, and data evaluation, the evidence-based guidelines for intraoperative use of dexmedetomidine are effective in reducing the incidence of postoperative tachyarrhythmias in congenital cardiac surgery patients, as well as a reduction in heart rate and invasive ventilation time. Utilizing the explored guidelines can lead to better patient outcomes, fewer complications, and a universal prevention protocol for anesthesia providers, providing consistently better results.