Adequate sedation with single-dose dexmedetomidine in patients undergoing transurethral resection of the prostate with spinal anaesthesia: a dose–response study by age group

Kim, Jeongmin; Kim, Won Oak; Kim, Hye-Bin; Kil, Hae Keum

doi:10.1186/1471-2253-15-17

Cited by 35 publications

(27 citation statements)

References 33 publications

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“…The adverse reactions included arrhythmia, tongue retraction, cough, agitation, hiccups, reflux and aspiration. Recovery time was measured using the Observer's Assessment of Alertness/Sedation scale (OAAS, Table 1 ) 7 , 8 . An OAAS score of 5 indicated rapid response to normal voice.…”

Section: Methodsmentioning

confidence: 99%

Clinical application of a novel endoscopic mask: A randomized controlled trial in aged patients undergoing painless gastroscopy

Cai¹,

Huang²,

Zou³

et al. 2017

Int. J. Med. Sci.

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Background: Desaturation during painless gastroscopy in aged patients leads to discontinuation of the procedure, prolonged manipulation time and increased risk of severe complications. An endoscopic nasal mask was designed to control hypoxia during the above procedures. A randomized trial was performed to test whether the novel endoscopic mask is helpful for hypoxia during painless gastroscopy in aged patients.Methods: In this randomized, controlled trial, 141 aged patients undergoing painless gastroscopy were randomized into nasal catheter group (69 patients) and endoscopic mask group (65 patients). Primary outcomes were minimum pulse oxygen saturation and incidence of pulse oxygen saturation ≤ 90%.Results: Finally, 134 aged patients were analyzed, including 69 patients in nasal catheter group and 65 patients endoscopic mask group. The minimum pulse oxygen saturation (96.4% ± 4.8%) was higher in the aged endoscopic mask group than in the aged nasal catheter group (94.3% ± 5.6%, P = 0.0075). The incidence of pulse oxygen saturation ≤ 90% did not significantly differ between the endoscopic mask group and nasal catheter group (6.2% VS 15.9%, P = 0.07). There were no severe adverse events in either groups.Conclusion: The endoscopic mask was safely used in aged patients during painless gastroscopy under propofol sedation and significantly improved the minimum pulse oxygen saturation without increasing time to examination or recovery time.

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Section: Methodsmentioning

confidence: 99%

Clinical application of a novel endoscopic mask: A randomized controlled trial in aged patients undergoing painless gastroscopy

Cai¹,

Huang²,

Zou³

et al. 2017

Int. J. Med. Sci.

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“…Recently, dexmedetomidine, a selective α 2 -adrenoreceptor agonist, was a focus of interest for sedation during regional anesthesia due to its rapid offset, prolongation of spinal anesthesia, and excellent postoperative analgesia characteristics [ 3 , 4 ]. In addition, dexmedetomidine has a biphasic hemodynamic effect, whereby an initial increase in blood pressure by α 2 -receptor-mediated peripheral vasoconstriction is followed by a decrease due to norepinephrine release and sympathetic activity inhibition in central nervous system [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Intravenous Dexmedetomidine and Midazolam for Bispectral Index-Guided Sedation During Spinal Anesthesia

Lee

Jung

et al. 2016

Med Sci Monit

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BackgroundDespite the high frequency of hypotension during spinal anesthesia with proper sedation, no previous report has compared the hemodynamic effects of dexmedetomidine and midazolam sedation during spinal anesthesia. We compared the effects of bispectral index (BIS)-guided intravenous sedation using midazolam or dexmedetomidine on hemodynamics and recovery profiles in patients who underwent spinal anesthesia.Material/MethodsOne hundred and sixteen adult patients were randomly assigned to receive either midazolam (midazolam group; n=58) or dexmedetomidine (dexmedetomidine group; n=58) during spinal anesthesia. Systolic, diastolic, and mean arterial pressures; heart rates; peripheral oxygen saturations; and bispectral index scores were recorded during surgery, and Ramsay sedation scores and postanesthesia care unit (PACU) stay were monitored.ResultsHypotension occurred more frequently in the midazolam group (P<0.001) and bradycardia occurred more frequently in the dexmedetomidine group (P<0.001). Mean Ramsay sedation score was significantly lower in the dexmedetomidine group after arrival in the PACU (P=0.025) and PACU stay was significantly longer in the dexmedetomidine group (P=0.003).ConclusionsBIS-guided dexmedetomidine sedation can attenuate intraoperative hypotension, but induces more bradycardia, prolongs PACU stay, and delays recovery from sedation in patients during and after spinal anesthesia as compared with midazolam sedation.

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“…Kim et al13 reported that the single dose of DEX required for sedation was 21% lower in older men (65–78 years old) compared to younger men (45–64 years old) who underwent transurethral resection of the prostate with spinal anesthesia. Our results show that among patients who underwent dental surgery under local anesthesia, the single dose of DEX required for sedation was 22.5% lower in the group aged 80 years and older compared to the group aged 70 to 74 years.…”

Section: Discussionmentioning

confidence: 99%

Sedation with dexmedetomidine in elderly patients during dental surgery: a retrospective case series

Seto

Kita

Kondo

2019

J Korean Assoc Oral Maxillofac Surg

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Objectives The number of elderly patients with systemic basal disease requiring invasive dental treatment has increased. Appropriate prediction of surgical invasiveness and combined use of psychosedation are thought to contribute to safe whole-body management. Dexmedetomidine (DEX) exhibits analgesic and anti-anxiolytic properties and causes mild respiratory depression. Studies regarding DEX use in elderly non-intubated patients are scarce. We aimed to use retrospective data to determine an effective dose of DEX to induce adequate sedation in elderly patients undergoing invasive dental surgery under local anesthesia. Materials and Methods One hundred two patients aged 70 to 96 years were presumably appropriately controlled with sedation. DEX was administered at an initial loading dose of 2.0 to 3.1 µg/kg/hr for 10 minutes. We divided the patients into five groups by age and compared their blood pressures and heart rates. Results In all five groups, blood pressure decreased suddenly at approximately 15 and 20 minutes after DEX administration. A marked decrease in blood pressure was noted in patients aged 75 to 79 years. Conclusion For elderly patients aged 75 years and above, the initial loading dose of DEX needs to be reduced to lower than half that required for young and middle-age adults.

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Adequate sedation with single-dose dexmedetomidine in patients undergoing transurethral resection of the prostate with spinal anaesthesia: a dose–response study by age group

Cited by 35 publications

References 33 publications

Clinical application of a novel endoscopic mask: A randomized controlled trial in aged patients undergoing painless gastroscopy

Clinical application of a novel endoscopic mask: A randomized controlled trial in aged patients undergoing painless gastroscopy

Comparison of Intravenous Dexmedetomidine and Midazolam for Bispectral Index-Guided Sedation During Spinal Anesthesia

Sedation with dexmedetomidine in elderly patients during dental surgery: a retrospective case series

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