Dexmedetomidine Pharmacodynamics: Part II

Cortínez, Luis Ignacio; Hsu, Yung-Wei; Sum-Ping, Sam T.; Young, Christopher C.; Keifer, John C.; MacLeod, David B.; Robertson, Kerri M.; Wright, David; Moretti, Eugene W.; Somma, Jacques

doi:10.1097/00000542-200411000-00006

Cited by 97 publications

(33 citation statements)

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“…The cardio-respiratory parameters, as is evident from Figures 1 and 2, remained stable throughout the study period which reaffirms the established effects of α-2 agonists in providing a haemodynamically stable peri-operative and post-operative period. [2539] Although a slight decrease in heart rate and mean arterial pressure was observed in both the groups, it never fell down to more than 15% of the baseline values. The side effect profile of both these drugs was quite favourable as none of the patient in either group had profound deep sedation or respiratory depression which correlates very well with other studies.…”

Section: Discussionmentioning

confidence: 95%

Dexmedetomidine and clonidine in epidural anaesthesia: A comparative evaluation

et al. 2011

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Efforts to find a better adjuvant in regional anaesthesia are underway since long. Aims and objectives are to compare the efficacy and clinical profile of two α-2 adrenergic agonists, dexmedetomidine and clonidine, in epidural anaesthesia with special emphasis on their sedative properties and an ability to provide smooth intra-operative and post-operative analgesia. A prospective randomized study was carried out which included 50 adult female patients between the ages of 44 and 65 years of (American Society of Anaesthesiologists) ASAI/II grade who underwent vaginal hysterectomies. The patients were randomly allocated into two groups; ropivacaine + dexmedetomidine (RD) and ropivacaine + clonidine (RC), comprising of 25 patients each. Group RD was administered 17 ml of 0.75% epidural ropivacaine and 1.5 μg/kg of dexmedetomidine, while group RC received admixture of 17 ml of 0.75% ropivacaine and 2 μg/kg of clonidine. Onset of analgesia, sensory and motor block levels, sedation, duration of analgesia and side effects were observed. The data obtained was subjected to statistical computation with analysis of variance and chi-square test using statistical package for social science (SPSS) version 10.0 for windows and value of P < 0.05 was considered significant and P < 0.0001 as highly significant. The demographic profile, initial and post-operative block characteristics and cardio-respiratory parameters were comparable and statistically non-significant in both the groups. However, sedation scores with dexmedetomidine were better than clonidine and turned out to be statistically significant (P < 0.05). The side effect profile was also comparable with a little higher incidence of nausea and dry mouth in both the groups which was again a non-significant entity (P > 0.05). Dexmedetomidine is a better neuraxial adjuvant compared to clonidine for providing early onset of sensory analgesia, adequate sedation and a prolonged post-operative analgesia.

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Section: Discussionmentioning

confidence: 95%

Dexmedetomidine and clonidine in epidural anaesthesia: A comparative evaluation

et al. 2011

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“…[18] Dexmedetomidine when administered as infusion at a dose of 0.5 mcg/kg/h has specific analgesic effect and provides visceral pain relief. [4] In morbidly obese, dexmedetomidine produces a greater decrease in sympathovagal balance intra-operatively than fentanyl along with better post-operative analgesia. [19] Dexmedetomidine, when used as sole substitute for remifentanil in ambulatory gynecologic laparoscopic surgery, provides better peri-operative hemodynamic stability and post-operative analgesia.…”

Section: Discussionmentioning

confidence: 99%

“…[23] The analgesic effect of dexmedetomidine is qualitatively different as compared to opioids and can be used as an alternative to opioids in general anesthesia. [456] The anesthetic sparing effect of dexmedetomidine demonstrated in earlier studies is confounded by the use of opioids. [78910111213] Opioids, when used as analgesic in general anesthesia, are known to decrease MAC value of sevoflurane.…”

Section: Introductionmentioning

confidence: 99%

The effect of dexmedetomidine continuous infusion as an adjuvant to general anesthesia on sevoflurane requirements: A study based on entropy analysis

Patel

Shah

Madhu

2013

J Anaesthesiol Clin Pharmacol

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Background:Dexmedetomidine, a α2 agonist as an adjuvant in general anesthesia, has anesthetic and analgesic-sparing property.Aims:To evaluate the effect of continuous infusion of dexmedetomidine alone, without use of opioids, on requirement of sevoflurane during general anesthesia with continuous monitoring of depth of anesthesia by entropy analysis.Materials and Methods:Sixty patients were randomly divided into 2 groups of 30 each. In group A, fentanyl 2 mcg/kg was given while in group B, dexmedetomidine was given intravenously as loading dose of 1 mcg/kg over 10 min prior to induction. After induction with thiopentone in group B, dexmedetomidine was given as infusion at a dose of 0.2-0.8 mcg/kg. Sevoflurane was used as inhalation agent in both groups. Hemodynamic variables, sevoflurane inspired fraction (FIsevo), sevoflurane expired fraction (ETsevo), and entropy (Response entropy and state entropy) were continuously recorded. Statistical analysis was done by unpaired student's t-test and Chi-square test for continuous and categorical variables, respectively. A P-value < 0.05 was considered significant.Results:The use of dexmedetomidine with sevoflurane was associated with a statistical significant decrease in ETsevo at 5 minutes post-intubation (1.49 ± 0.11) and 60 minutes post-intubation (1.11 ±0.28) as compared to the group A [1.73 ±0.30 (5 minutes); 1.68 ±0.50 (60 minutes)]. There was an average 21.5% decrease in ETsevo in group B as compared to group A.Conclusions:Dexmedetomidine, as an adjuvant in general anesthesia, decreases requirement of sevoflurane for maintaining adequate depth of anesthesia.

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“…The anaesthetic and analgesic sparing effects of a 2 -adrenoceptor agonists in general and dexmedetomidine in particular are also well established [23][24][25]. In the postoperative period, time to first analgesic requirement in the placebo group was earlier than in the dexmedetomidine group.…”

Section: Discussionmentioning

confidence: 99%