Effect of low dose dexmedetomidine premedication on propofol consumption in geriatric end stage renal disease patients

Ergenoğlu, Pınar; Akın, Şule; Bali, Çağla; Eker, H. Evren; Çok, Oya Yalçın; Ariboğan, Anış

doi:10.1016/j.bjane.2014.11.002

Cited by 3 publications

(4 citation statements)

References 25 publications

(19 reference statements)

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“…In previous studies applying single‐ or initial‐dose dexmedetomidine sedation in elderly patients, bradycardia and hypotension were the most common side‐effects, and occurred more frequently with dexmedetomidine doses exceeding 0.5 μg/kg 8, 18, 19, 20, 21. Although a previous study reported that maintenance doses of up to 10 μg/kg per hour were tolerated,27 without producing hypotension or bradycardia, when used as a total intravenous anesthetic agent in certain patients, there are other case reports in which the use of dexmedetomidine in elderly patients was associated with the occurrence of severe bradycardia or hypotension,27, 28 sometimes even progressing to asystole.…”

Section: Discussionmentioning

confidence: 97%

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Effective dose of dexmedetomidine as an adjuvant sedative to peripheral nerve blockade in elderly patients

Wang

Zhang

2018

Acta Anaesthesiol Scand

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BackgroundThe median effective dose (ED 50) of sedative dexmedetomidine adjuvant to peripheral nerve block (PNB) has not yet been verified in elderly patients. This study assessed the ED 50 of intravenous dexmedetomidine for sedation in elderly patients who were undergoing total knee arthroplasty (TKA) with PNB.MethodsForty‐two patients aged 65–85 years were included and stratified into two groups according to age: young‐old group (aged 65–74 years) and middle‐old group (aged 75–85 years). After the PNB was performed, a pre‐calculated dose of dexmedetomidine was administered for 10 min. The Observer's Assessment of Alertness/Sedation scale, bispectral index score, blood pressure and heart rate were recorded. ED 50 values of dexmedetomidine for adequate sedation were estimated by the up‐and‐down method of Dixon and probit regression.ResultsThe ED 50 of single‐dose dexmedetomidine adjuvant to PNB was 0.57 μg/kg (95% confidence interval [CI], 0.47–0.65) in the young‐old group and 0.38 μg/kg (95% CI, 0.28–0.46) in the middle‐old group. The ED 50 of dexmedetomidine differed significantly between the two groups (P < 0.001). In addition, no significant adverse hemodynamic or hypoxemic effects were noted.ConclusionWe determined the ED 50 for sedation using intravenous dexmedetomidine adjuvant to PNB in elderly patients. The ED 50 of dexmedetomidine in the middle‐old group decreased by 33% compared with that in the young‐old group with a mean age difference of 11 years between the two groups.

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Section: Discussionmentioning

confidence: 97%

“…Previous studies have described administration of single‐ or initial‐dose dexmedetomidine in elderly patients sedation 8, 18, 19, 20, 21. Generally, doses ranging from 0.5–1.0 μg/kg delivered as a 10‐min infusion were associated with excessive sedation, bradycardia, hypotension, desaturation, or delayed recovery.…”

Section: Discussionmentioning

confidence: 99%

Effective dose of dexmedetomidine as an adjuvant sedative to peripheral nerve blockade in elderly patients

Wang

Zhang

2018

Acta Anaesthesiol Scand

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“…DEX is highly selective α 2 -adrenergic agonist, and is widely used for anxiolysis, sedation, and analgesia. 4 , 5 Recently, studies have demonstrated the protective benefits of DEX, which are exerted through its anti-inflammatory properties. 6 – 9 Administration of DEX could alleviate systemic inflammation in animals through stabilization of the sympathetic nervous system.…”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine (DEX) is a highly selective α 2 -adrenergic agonist that has demonstrated sedative, analgesic, and anxiolytic effects. 4 , 5 Beyond these benefits, emerging data show that the medication also exhibits anti-inflammatory properties. 6 – 9 Treatment with DEX has been shown to attenuate the release of cytokines in cells stimulated by endotoxin in a dose-dependent manner in in vitro studies.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative dexmedetomidine attenuates postoperative systemic inflammatory response syndrome in patients who underwent percutaneous nephrolithotomy: a retrospective cohort study

Tan

Gan

Deng

et al. 2018

TCRM

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PurposeDexmedetomidine (DEX) has been reported to attenuate inflammation in rats. The present retrospective cohort study aimed to investigate whether intraoperative administration with DEX could reduce the incidence of postoperative systemic inflammatory response syndrome (SIRS) in patients following percutaneous nephrolithotomy (PCNL).Patients and methodsA total of 251 patients were included in the analysis. Among these patients, 175 received intravenous DEX infusion during the intraoperative period and 76 did not. The primary outcome measures were the incidences of postoperative SIRS and fever. Secondary outcomes included patient-controlled analgesia (tramadol) requirements, length of postoperative hospitalization stay, serum creatinine (Scr) and serum blood urea nitrogen (BUN) concentration, and adverse events (bradycardia, hypotension, renal artery thrombosis).ResultsAdministration of DEX not only significantly attenuated the incidence of SIRS and fever (P=0.029, P=0.042, respectively), but also reduced analgesia requirements (P=0.028). The length of postoperative hospitalization stay, Scr and BUN concentration, and adverse events did not differ significantly between the two groups. Further univariate and multivariate logistic regression analysis indicated that intraoperative DEX administration was a protective factor against SIRS after PCNL (OR 0.476 [95% CI: 0.257–0.835]; P=0.019).ConclusionIntraoperative administration of DEX might be associated with reductions in the incidences of SIRS and fever after PCNL.

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Effect of dexmedetomidine added to ropivicaine for caudal anesthesia in patients undergoing hemorrhoidectomy

De-ming

Xiu²,

Zhang³

et al. 2018

Medicine

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Background:To assess the effect of dexmedetomidine added to ropivaccaine on the onset and duration of sensory block, as well as postoperative analgesia during caudal anesthesia in patients undergoing hemorrhoidectomy.Methods:Fifty adult patients scheduled for hemorrhoidectomy were divided into 2 groups. The group R received caudal anesthesia using 18 mL 0.3% ropivacaine plus 2 mL normal saline. The group RD received 18 mL 0.3% ropivacaine plus 2 mL 1 μg/kg dexmedetomidine. Heart rate, mean blood pressure, onset time and duration of sensory block, and duration of analgesia were observed.Results:The onset time of sensory block was shortened (9.2 ± 1.3 vs 7.2 ± 1.2), and the duration of sensory block (3.0 ± 0.7 vs 3.8 ± 0.8) and duration of analgesia (3.9 ± 0.7 vs 5.3 ± 0.8) were prolonged in group RD compared with group R (P < .05). The heart rate and the mean blood pressure were also lower in the group RD compared with group R at each observation time points, except the baseline (P < .05). No bradycardia or hypotension was reported.Conclusion:Dexmedetomidine as an adjuvant to ropivacaine prolonged the duration of caudal block and improved postoperative analgesia without significant side effects in adult patients undergoing hemorrhoidectomy.

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Effect of low dose dexmedetomidine premedication on propofol consumption in geriatric end stage renal disease patients

Abstract: Dexmedetomidine premedication lowers intraoperative propofol consumption to maintain targeted level of sedation. Therefore low dose dexmedetomidine premedication in addition to propofol infusion might be an alternative in geriatric patients with end-stage renal disease for sedation.

Cited by 3 publications

References 25 publications

Effective dose of dexmedetomidine as an adjuvant sedative to peripheral nerve blockade in elderly patients

Effective dose of dexmedetomidine as an adjuvant sedative to peripheral nerve blockade in elderly patients

Intraoperative dexmedetomidine attenuates postoperative systemic inflammatory response syndrome in patients who underwent percutaneous nephrolithotomy: a retrospective cohort study

Effect of dexmedetomidine added to ropivicaine for caudal anesthesia in patients undergoing hemorrhoidectomy

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