The effect of low-dose dexmedetomidine on hemodynamics and anesthetic requirement during bis-spectral index-guided total intravenous anesthesia
- Authors
- Park, Hee Yeon; Kim, Jong Yeop; Cho, Sang Hyun; Lee, Dongchul; Kwak, Hyun Jeong
- Issue Date
- Aug-2016
- Publisher
- SPRINGER HEIDELBERG
- Keywords
- Anesthetic requirement; Dexmedetomidine; Hemodynamics; Propofol; Remifentanil
- Citation
- JOURNAL OF CLINICAL MONITORING AND COMPUTING, v.30, no.4, pp.429 - 435
- Journal Title
- JOURNAL OF CLINICAL MONITORING AND COMPUTING
- Volume
- 30
- Number
- 4
- Start Page
- 429
- End Page
- 435
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/8030
- DOI
- 10.1007/s10877-015-9735-2
- ISSN
- 1387-1307
- Abstract
- The purpose of this study was to evaluate the effects of low-dose dexmedetomidine on hemodynamics and anesthetic requirements during propofol and remifentanil anesthesia for laparoscopic cholecystectomy. Thirty adult patients were randomly allocated to receive dexmedetomidine infusion of 0.3 mu g/kg/h (dexmedetomidine group, n = 15) or comparable volumes of saline infusion (control group, n = 15). Target controlled infusion of propofol and remifentanil was used for anesthetic induction and maintenance, and adjusted in order to maintain a bispectral index of 40-55 and hemodynamic stability. We measured hemodynamics and recorded total and mean infused dosages of propofol and remifentanil. For anesthesia induction and maintenance, mean infused doses of propofol (121 +/- 27 vs. 144 +/- 29 mu g/kg/min, P = 0.04) and remifentanil (118 +/- 27 vs. 150 +/- 36 ng/kg/min, P = 0.01) were lower in the dexmedetomidine group than in the control group, respectively. The dexmedetomidine group required 16 % less propofol and 23 % less remifentanil. During anesthetic induction and maintenance, the dexmedetomidine group required fewer total doses of propofol (9.6 +/- 2.3 vs. 12.4 +/- 3.3 mg/kg, P = 0.01) and remifentanil (9.6 +/- 3.4 vs. 12.7 +/- 2.6 mu g/kg, P = 0.01). The change in mean arterial pressure over time differed between the groups (P < 0.05). Significantly lower mean arterial pressure was observed in the dexmedetomidine group than in the control group at immediately and 5 min after pneumoperitoneum. The time to extubation after completion of drug administration did not differ between the groups (P = 0.25). This study demonstrated that a low-dose dexmedetomidine infusion of 0.3 mu g/kg/h reduced propofol and remifentanil requirements as well as hemodynamic change by pneumoperitoneum without delayed recovery during propofol-remifentanil anesthesia for laparoscopic cholecystectomy.
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