Does dexmedetomidine affect intraoperative blood loss and clotting tests in pediatric adenotonsillectomy patients?

Mızrak, Ayşe; Karataş, Erkan; Saruhan, Reşit; Kara, Ferit; Öner, Ünsal; Sarıçiçek, Vahap; Baysal, Elif

doi:10.1016/j.jss.2012.09.014

Cited by 18 publications

(17 citation statements)

References 24 publications

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“…In our study, we showed that in the D group, the rise of NT-pro-BNP was less than in the control group, which is in agreement with the survey (Biccard et al, 2008). Mizrak et al evaluated the effect of DEX on intraoperative blood loss in pediatric adenotonsillectomy and they concluded that dexmedetomidine slightly increased bleeding during the operation (Mizrak et al, 2013). These results are different from our findings because we evaluated the effect of dexmedetomidine infusion during operation, but in Mizrak et al, (2013) study, they evaluated only a bolus dose of the drug as premedication.…”

Section: Discussionsupporting

confidence: 90%

“…Mizrak et al evaluated the effect of DEX on intraoperative blood loss in pediatric adenotonsillectomy and they concluded that dexmedetomidine slightly increased bleeding during the operation (Mizrak et al, 2013). These results are different from our findings because we evaluated the effect of dexmedetomidine infusion during operation, but in Mizrak et al, (2013) study, they evaluated only a bolus dose of the drug as premedication. In the systematic review of Biccard et al they evaluated the effects of dexmedetomidine on cardiac outcomes after non-cardiac surgery.…”

Section: Discussioncontrasting

confidence: 86%

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Effect of dexmedetomidine infusion on N-terminal pro-B-type natriuretic peptide level in patients with femoral shaft fractures under general anesthesia

Mirkheshti

Memary

Shafiee

et al. 2016

Bangladesh J Pharmacol

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This study was performed to assess the effect of dexmedetomidine on the level of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) in patients undergoing major orthopedic surgery. Patients undergoing general anesthesia for femoral shaft fracture surgery were randomly assigned to either 0.5 µg/ kg/hour dexmedetomidine or normal saline. Changes in levels of NT-pro-BNP and hemodynamic parameters were compared. Data of 46 patients were analyzed and it was found that the change in NT-pro-BNP levels in the dexmedetomidine group was significantly less than the control group (p = 0.001). In addition, bleeding, changes in systolic and diastolic blood pressure in dexmedetomidine group was significantly less than the control group (p˂0.001). It is likely that dexmedetomidine infusion can reduce the rise of NT -pro-BNP level and therefore is associated with better cardiac outcome. In addition, dexmedetomidine infusion can achieve hemodynamic stability in femoral shaft fracture under general anesthesia.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 86%

Effect of dexmedetomidine infusion on N-terminal pro-B-type natriuretic peptide level in patients with femoral shaft fractures under general anesthesia

Mirkheshti

Memary

Shafiee

et al. 2016

Bangladesh J Pharmacol

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show abstract

“…Durmus et al (2007) demonstrated that dexmedetomidine decreased bleeding in patients undergoing elective tympanoplasty and septorhinoplasty under general anesthesia. In contrast, Mizrak et al (2013) reported that dexmedetomidine increased bleeding in pediatric patients undergoing adenotonsillectomy. Our results demonstrated that dexmedetomidine has both enhancing and suppressive effects on platelet functions, and that a drug with α 2 -antagonist-like activity affects which of the two opposite effects becomes evident.…”

Section: Discussionmentioning

confidence: 92%

Bidirectional effects of dexmedetomidine on human platelet functions in vitro

Kawamoto

Hirakata

Sugita

et al. 2015

European Journal of Pharmacology

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Platelets express the imidazoline (I)-receptor, I1 and I2, as well as the α2-adrenoceptor. Although dexmedetomidine, a selective α2-adrenoceptor agonist with some affinity for the I-receptor is expected to affect platelet function, the effects of dexmedetomidine on platelet functions remain unclear. In the present study, we investigated the effects of dexmedetomidine on human platelet functions in vitro. The effects of dexmedetomidine on platelet aggregation were examined using aggregometers. The formation of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) in platelets was measured by an enzyme immunoassay. In addition, P-selectin expression in platelets was estimated by flow cytometry. We showed that dexmedetomidine enhances platelet aggregation. But in the presence of yohimbine, an α2-antagonist, dexmedetomidine suppressed platelet aggregation. Efaroxan, an I1-antagonist, and methylene blue, a soluble guanylate cyclase inhibitor, abolished the suppressive effect of dexmedetomidine, whereas idazoxan, an I2-antagonist, showed no effect. Dexmedetomidine suppressed cAMP formation and enhanced P-selectin expression in platelets, and these effects were inhibited by yohimbine. Dexmedetomidine increased cGMP formation in platelets in the presence of yohimbine, and this increase was suppressed by efaroxan. These results demonstrated that dexmedetomidine has both enhancing and suppressive effects on human platelet functions through its action on the α2-adrenoceptor and on the I1-imidazoline receptor, respectively.

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“…Fifteen studies with 1,552 participants were included for the meta-analysis, and the results of the study characteristics were described in Table I. Outcomes for analysis were postoperative pain (pain scores) in the postanesthesia care unit (PACU), [10][11][12][13][14][15][16][17][18] postoperative analgesic requirements (doses of postoperative opioids or nonopioid analgesics), 4,8,[10][11][12]16,17,[19][20][21][22][23][24][25][26][27][28][29][30] postoperative agitation (agitation scores and incidence during recovery), 8,10,11,13,[15][16][17][18][19][21][22][23]31 desaturation, 8,10,15,17,18,20,…”

Section: Data Extraction and Risk Of Bias Assessmentmentioning

confidence: 99%

Efficacy of dexmedetomidine for perioperative morbidities in pediatric tonsillectomy: A metaanalysis

Cho¹,

Yoon

Jin

et al. 2017

The Laryngoscope

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Does dexmedetomidine affect intraoperative blood loss and clotting tests in pediatric adenotonsillectomy patients?

Cited by 18 publications

References 24 publications

Effect of dexmedetomidine infusion on N-terminal pro-B-type natriuretic peptide level in patients with femoral shaft fractures under general anesthesia

Effect of dexmedetomidine infusion on N-terminal pro-B-type natriuretic peptide level in patients with femoral shaft fractures under general anesthesia

Bidirectional effects of dexmedetomidine on human platelet functions in vitro

Efficacy of dexmedetomidine for perioperative morbidities in pediatric tonsillectomy: A metaanalysis

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