Dexmedetomidine Reduces Propofol and Remifentanil Requirements During Bispectral Index–Guided Closed-Loop Anesthesia

Guen, Morgan Le; Liu, Ngai; Tonou, Felix; Augé, Marion; Tuil, Olivier; Chazot, Thierry; Dardelle, Dominique; Laloë, Pierre-Antoine; Bonnet, Francis; Sessler, Daniel I.; Fischler, Marc

doi:10.1097/sa.0000000000000089

Cited by 10 publications

(16 citation statements)

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“…Other authors have shown that dexmedetomidine can be added to propofol sedation and will decrease the propofol requirement to achieve optimal sedation or total intravenous anesthesia for surgical procedures. In these reports, the recommended loading dose (1 μg/kg infusion over 10 minutes) with or without maintenance (0.4‐1.0 μg/kg/h) was combined with a propofol infusion . Le Guen reported that dexmedetomidine decreased the propofol requirement by 30% .…”

Section: Discussionmentioning

confidence: 99%

“…In these reports, the recommended loading dose (1 μg/kg infusion over 10 minutes) with or without maintenance (0.4‐1.0 μg/kg/h) was combined with a propofol infusion . Le Guen reported that dexmedetomidine decreased the propofol requirement by 30% . A common practice in our institution is to administer a half of the recommended loading dose of dexmedetomidine.…”

Section: Discussionmentioning

confidence: 99%

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Low‐dose dexmedetomidine as an adjuvant to propofol infusion for children in MRI: A double‐cohort study

Nagoshi

Reddy

Bell

et al. 2018

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Low‐dose dexmedetomidine as an adjuvant to propofol infusion for children in MRI: A double‐cohort study

Nagoshi

Reddy

Bell

et al. 2018

Pediatric Anesthesia

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“…Le Guen et al [19] studied the administration of dexmedetomidine in combination with propofol and reported that dexmedetomidine decreased the propofol requirement. Various other researchers have also reported that dexmedetomidine decreased the MAC of inhalational anesthetics [8,20,21].…”

Section: Discussionmentioning

confidence: 99%

Effect of dexmedetomidine on endotracheal intubating conditions during endotracheal intubation without neuromuscular blocker following propofol/remifentanil

Noh

Kim

et al. 2017

Anesth Pain Med

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:In the present study, we investigated the effect of dexmedetomidine on the intubating conditions and hemodynamic changes during endotracheal intubation following anesthetic induction performed using propofol and remifentanil without a neuromuscular blocking agent. Methods: We selected 70 adult patients aged 20 to 65 years scheduled to undergo general anesthesia. Induction was performed using 2 mg/kg of propofol and 1.5 g/kg of remifentanil. The patients were divided into two groups, a dexmedetomidine group (Group D) and a control group (Group C). Group D received an infusion of dexmedetomidine 1 g/kg for 10 minutes before induction, and Group C received the same volume of normal saline infused in the same manner. Intubating conditions were evaluated and blood pressure and heart rate were recorded at various time points to assess hemodynamic stability. Results: Intubating conditions were evaluated as excellent for 34 patients and good for 1 patient in Group D, and excellent for 4 patients, good for 20 patients, poor for 4 patients, and bad for 7 patients in Group C (P ＜ 0.001). The heart rate was significantly lower in Group D than in Group C at all measurement times. The mean arterial blood pressure was significantly lower in Group C than in Group D at 10 minutes after dexmedetomidine administration (P = 0.049), after the induction of anesthesia (P ＜ 0.001), immediately after endotracheal intubation (P = 0.008), and 3 minutes after endotracheal intubation (P ＜ 0.001). Conclusions: Dexmedetomidine 1 g/kg improved the intubating conditions and stabilized hemodynamic changes following anesthetic induction performed using propofol 2 mg/kg and remifentanil 1.5 g/kg without a neuromuscular blocking agent.

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“…On the other hand, a small bolus of remifentanil is performed when a fast decrease of ANIi is observed. device has already been extensively tested and has shown its added value in evaluating non-opioid analgesic drugs and measuring objectively the induced opioid sparing effect [43] or in specific populations where analgesic dosage is difficult, e. g. morbidly obese patients [9]. The closed-loop device for remifentanil administration developed by De Jonckheere J et al has only been tested on a simulated environment [52].…”

Section: Closed-loop Opioid Administrationmentioning

confidence: 99%

Closed-loop Administration of General Anaesthesia: From Sensor to Medical Device

Jeanne

Tavernier

Logier

et al. 2017

Pharmaceutical Technology in Hospital Pharmacy

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AbstractClosed-loop administration devices for general anaesthesia have become a common subject of clinical research over the last decade and appear more and more acceptable in clinical practice. They encompass various therapeutic needs of the anesthetized patient, e. g. fluid administration, hypnotic and analgesic drug administration, myorelaxation. Multiple clinical trials involving closed-loop devices have underscored their safety, but data concerning their clinical benefit to the patient are still lacking. As the marketing of various devices increases, clinicians need to understand how comparisons between these devices can be made: the measure of performance error and wobble are technical but have also a clinical meaning, to which clinical outcomes can be added, such as drug consumption and maintenance of hemodynamic parameters (e. g. heart rate and blood pressure) within predefined ranges. Clinicians using closed-loop devices need especially to understand how various physiological signals lead to specific drug adaptations, which means that they switch from decision making to supervision of general anaesthesia.

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Dexmedetomidine Reduces Propofol and Remifentanil Requirements During Bispectral Index–Guided Closed-Loop Anesthesia

Cited by 10 publications

References 1 publication

Low‐dose dexmedetomidine as an adjuvant to propofol infusion for children in MRI: A double‐cohort study

Low‐dose dexmedetomidine as an adjuvant to propofol infusion for children in MRI: A double‐cohort study

Effect of dexmedetomidine on endotracheal intubating conditions during endotracheal intubation without neuromuscular blocker following propofol/remifentanil

Closed-loop Administration of General Anaesthesia: From Sensor to Medical Device

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