Dexmedetomidine Attenuates Sympathoadrenal Responses to Tracheal Intubation and Reduces the Need for Thiopentone and Peroperative Fentanyl

Abstract

The effects of the new, highly selective alpha 2-adrenergic agonist, dexmedetomidine, were studied in a randomized, placebo-controlled, double-blind trial in 24 ASA I patients. Dexmedetomidine 0.6 micrograms kg-1 or saline was given i.v. 10 min before induction of anaesthesia. The required dose of thiopentone was significantly (P less than 0.001) smaller in the dexmedetomidine group (mean 4.4 (sd 0.9) mg kg-1) than in the control group (6.9 (1.6) mg kg-1), and the drug attenuated the cardiovascular responses to laryngoscopy and tracheal intubation. The concentration of noradrenaline in mixed venous plasma was smaller in the dexmedetomidine group during all phases of induction (P less than 0.01). During surgery, fentanyl was required in a dose of 0.5 (0.6) mg kg-1 and 2.8 (2.6) mg kg-1 in the dexmedetomidine and control groups, respectively (P less than 0.001). During 2 h postoperative follow-up, oxycodone 0.06 (0.06) mg kg-1 and 0.16 (0.1) mg kg-1 (P less than 0.05) was given to the two groups respectively.

The Effects of Local Anaesthetics on QT Parameters during Thoracic Epidural Anaesthesia Combined with General Anaesthesia: Ropivacaine versus Bupivacaine

“…Scheinin et al (22) found a close correlation between plasma noradrenaline concentration and the QTc interval. In the present study, QT and QTc durations were increased compared with basal values during laryngoscopy and in the various phases of the post-intubation period in the groups.…”

Alpha‐2 and imidazoline receptor agonistsTheir pharmacology and therapeutic role

“…Aho and colleagues [138] reported that the administration of an infusion of dexmedetomidine in patients undergoing abdominal hysterectomy was able to reduce isoflurane requirements by 90%. Dexmedetomidine has also been reported to be opioid-and barbiturate sparing [139].…”

A Prospective Randomised Control Study to Assess the Efficacy of Intraoperative Dexmed Infusion on Emergence Agitation and Quality of Recovery in Nasal Surgery

“…13 General anaesthesia was induced by the use of fentanyl 1 mcg/kg and propofol 1.5-2 mg/kg, inj. vecuronium 0.1 mg/kg was used to facilitate endotracheal intubation.…”

“…However, Group D demonstrated more stable haemodynamic changes during the emergence period compared with Group C (Bonferroni corrected P<0.05). 17,13,15 During the operation, ephedrine was administered to seven patients in Group D and four patients in Group C (P=0.338), while esmolol was administered to six patients in Group C and no patients in Group D (P=0.027). No patient in either group experienced bradycardia.…”