The effects of perioperative low-moderate doses of dexmedetomidine infusion on hemodynamic and neuroendocrine parameters

WOS: 000254179000011Aim: The aim of this study was to determine the effects of low and moderate doses of dexmedetomidine infusions by evaluating hemodynamic and neuroendocrine responses in patients undergoing elective transurethral surgery. Materials and Methods: Fifty patients were randomly allocated to receive 0.45 (Group 1) or 0.6 (Group 2) mu g kg(-1) hr(-1) dexmedetomidine infusion 10 minutes before induction of anesthesia. Heart rate, blood pressures, ETCO2 and peripheral oxygen saturation values and parameters of non-invasive cardiac output were monitored. Measurement times were baseline (I), after dexmedetomidine infusion (II), after thiopental induction (III), after intubation (IV) and at 10-minute intervals during desflurane anesthesia. Anesthesia (2L min(-1) 50% N2O+O-2) was maintained with 4-6% desflurane corresponding to a bispectral index (BIS) value of 40-60. Venous blood samples were collected prior to intubation (I), at the 30(th) min intraoperatively (II) and after extubation (III) to determine plasma adrenaline and noradrenaline levels. Chi-square, Student's t-test and repeated measures of variance were used for statistical analysis. Results: Two different doses of dexmedetomidine infusion produced similar hemodynamic effects. The cardiovascular and neuroendocrine parameters were suppressed more in Group 2 than in Group 1. Conclusions: These findings suggest that intraoperative 0.45 and 0.6 mu g kg(-1) hr(-1) doses of dexmedetomidine result in similar intubation, recovery and hemodynamic responses. Cardiovascular and neuroendocrine parameters were suppressed more by the moderate dose of dexmedetomidine

Magnesium sulphate infusion is not effective on discomfort or emergence phenomenon in paediatric adenoidectomy/tonsillectomy

WOS: 000285176800005PubMed: 20880596Objective: This study was performed to evaluate the possible influence of magnesium sulphate which has sedative and analgesic properties on sevoflurane-induced emergence agitation in paediatric patients undergoing adenoidectomy with or without tonsillectomy. Methods: One hundred and ten paediatric patients aged between 3 and 16 years were randomly allocated to the study. Propofol 2-2.5 mg kg(-1), vecuronium 0.1 mg kg(-1) and fentanyl 1 mu g kg(-1) were used for induction of anesthesia and sevoflurane at 1 MAC with nitrous oxide in oxygen (35%) mixture was administered as maintenance. Magnesium sulfate 30 mg kg(-1) in saline (20 mL) in the Group M, or equal volume of saline for controls (Group C) was started 10 min before and infused until the end of the operation. Recovery characteristics included time to extubation, eyes open, emergence and interaction. Patients were evaluated using Modified Aldrete Score (MAS), Pain/Discomfort Scale and Agitation Score. Side effects were determined during emergence and in the recovery. Results: Time to open eyes was significantly higher in the magnesium treatment group (Group C: 7.7 +/- 3.5, Group M: 12.7 +/- 17.5 min, p = 0.001). Agitation score was significantly lower in Group M at the 60th min (Group C: 1.3 +/- 0.7, Group M: 1.0 +/- 0.3, p = 0.005). Agitation or pain/discomfort scores in the resting observation periods were the same. The initial MAS value was lower in Group M (Group C: 5.0 +/- 1.9, Group M: 4.0 +/- 1.7, p = 0.003). There was no significant difference between groups regarding side effects. Conclusion: Magnesium sulphate infusion has no influence on sevoflurane-induced discomfort or emergence agitation. (C) 2010 Elsevier Ireland Ltd. All rights reserved

The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters

WOS: 000260134200006PubMed: 18929283Study Objectives: To investigate the hemodynamic, cardiovascular, and recovery effects of dexmedetomidine used as a single preanesthetic dose. Design: Randomized, prospective, double-blind study. Setting: University Hospital of Kirikkale, Kirikkale, Turkey. Patients: 40 ASA physical status I and II patients, aged 20 to 60 years, who were scheduled for elective cholecystectomy. Interventions: Patients were randomly divided into two groups to receive 0.5 mu g kg(-1) dexmedetomidine (group D, n = 20) or saline solution (group C, n = 20). Anesthesia was induced with thiopental sodium and vecuronium, and anesthesia was maintained with 4% to 6% desflurane. Measurements: Mean arterial pressure (MAP), heart rate (HR), (ejection fraction (EF), end-diastolic index (EDI), cardiac index (CI), and stroke volume index (SVI) were recorded at 10-minute intervals. The times for patients to "open eyes on verbal command" and postoperative Aldrete recovery scores were also recorded. Main Results: In group C, an increase in HR and MAP occurred after endotracheal intubation. In group D, HR significantly decreased after dexmedetomidine was given. The EDI, Cl, SVI, and EF values were similar in groups D and C. The modified Aldrete recovery scores of patients in the recovery room were similar in groups C and D at the 15th minute. Conclusions: A single dose of dexmedetomidine given before induction of anesthesia decreased thiopental requirements without serious hemodynamic effects or any effect on recovery time. Crown Copyright (C) 2008 Published by Elsevier Inc. All rights reserved