{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:25:05Z","timestamp":1787837105790,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"\n Objective:<\/jats:title>\n The aim of the study was to assess the effect of dexmedetomidine on the incidence of paradoxical hypertension in patients undergoing aortic coarctation repair.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Randomized observational study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n University hospital and cardiac center.<\/jats:p>\n <\/jats:sec>\n \n Patients:<\/jats:title>\n The study included 108 pediatric patients with isolated aortic coarctation.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n The patients were classified into two groups (each = 54): Group D: the patients received dexmedetomidine as a loading dose of 0.5 \u03bcg\/kg over 10 min followed by infusion 0.3 \u03bcg\/kg\/h during surgery and continued for the first 48 postoperative hours. Group C: The patients received an equal amount of normal saline. The medication was prepared by the nursing staff and given to anesthetist blindly. The collected data included the heart rate, systolic and diastolic arterial blood pressure, incidence, onset, severity and treatment of paradoxical hypertension, fentanyl dose and end-tidal sevoflurane concentration, amount of blood loss and urine output.<\/jats:p>\n <\/jats:sec>\n \n Main Results:<\/jats:title>\n \n The heart rate, systolic and diastolic blood pressure decreased significantly with dexmedetomidine than Group C (\n P<\/jats:italic>\n < 0.05). The incidence and severity of the paradoxical hypertension was lower with dexmedetomidine than Group C (\n P<\/jats:italic>\n = 0.011,\n P<\/jats:italic>\n = 0.017, respectively). The onset the paradoxical hypertension was earlier in Group C than dexmedetomidine (\n P<\/jats:italic>\n = 0.026). The dose of fentanyl and sevoflurane concentration decreased significantly with dexmedetomidine (\n P<\/jats:italic>\n = 0.034,\n P<\/jats:italic>\n = 0.026, respectively). The blood loss decreased with dexmedetomidine (\n P<\/jats:italic>\n = 0.020) and the urine output increased with dexmedetomidine (\n P<\/jats:italic>\n = 0.024). The incidence of hypotension and bradycardia was more with dexmedetomidine (\n P<\/jats:italic>\n < 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Dexmedetomidine is safe in pediatric patients undergoing aortic coarctation repair. It minimized the incidence and severity of paradoxical hypertension. It decreased the required antihypertensive medications.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aca.aca_23_17","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T06:37:25Z","timestamp":1716878245000},"page":"26-33","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Assessment the Effect of Dexmedetomidine on Incidence of Paradoxical Hypertension After Surgical Repair of Aortic Coarctation in Pediatric Patients"],"prefix":"10.4103","volume":"21","author":[{"given":"Rabie","family":"Soliman","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalia","family":"Saad","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250602","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1016\/j.ijcard.2012.09.084","article-title":"Hypertension after repair of aortic coarctation \u2013 A systematic review","volume":"167","author":"Canniffe","year":"2013","journal-title":"Int J Cardiol"},{"key":"R2-20250602","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S1569-9293(02)00115-9","article-title":"Comparison of sodium nitroprusside versus esmolol for the treatment of hypertension following repair of coarctation of the aorta","volume":"2","author":"Dittrich","year":"2003","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"R3-20250602","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/0003-4975(90)90768-2","article-title":"Paradoxical hypertension after repair of coarctation of the aorta: A review of its causes","volume":"50","author":"Sealy","year":"1990","journal-title":"Ann Thorac Surg"},{"key":"R4-20250602","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1161\/01.CIR.39.3.345","article-title":"Increased sympathetic nerve activity following resection of coarctation of the thoracic aorta","volume":"39","author":"Goodall","year":"1969","journal-title":"Circulation"},{"key":"R5-20250602","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1161\/01.CIR.40.5.731","article-title":"Plasma renin activity in patients with coarctation of the aorta. 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