Efficacy of Dexmedetomidine Infusion Without Loading Dose as a Potent Hypotensive Agent in Lumbar Fixation Surgery

Moharram, Assem Adel; Mostafa, Raham Hasan

doi:10.2174/2589645801913010068

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…Group A received dexmedetomidine infusion in a dose of 0.5 µg/kg/hour, it stimulates a biphasic response of blood pressure: A short initial hypertensive period followed by hypotension. It is found that hypotension and bradycardia will happen with ongoing therapy within 15 minutes, due to its effect on central a2 adrenergic receptor agonist which decreases the release of noradrenaline from the sympathetic nervous system [10], that is why we started dexmedetomidine infusion just after intubation.…”

Section: Methodsmentioning

confidence: 99%

The efficacy of adding dexmedetomidine perineurally in fascia iliaca compartment block versus intravenously in hip arthroscopy: A randomized controlled trial

Ibrahim¹,

Elderh²,

Abdelsalam³

2023

Rev. chil. anest.

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Background: Stable hemodynamics in hip arthroscopy is one of the most important tasks. Recently, dexmedetomidine has been considered a safe analgesic and sedative adjuvant in different surgeries. Ultrasound-guided fascia iliaca compartment block (FICB) is a technique used to produce postoperative analgesia for hip surgery. FICB will be a promising technique for postoperative analgesia in hip arthroscopy. Objective: We designed a prospective, randomized, double-blind, parallel-group trial to evaluate the effect of administration of dexmedetomidine intravenously and perineurally on hemodynamic stability intraoperatively and on narcotics consumption postoperatively, as well as to evaluate the effect of dexmedetomidine as an adjuvant to FICB. Patients: A total of 88 patients scheduled for elective hip arthroscopy, aged 18 to 65 years, 70-80 kg, both sexes. Patients were randomized into Group A (intravenous Dexmedetomidine) and Group B (perineural Dexmedetomidine). The Main outcome measure was to detect effectiveness of dexmedetomidine infusion without loading dose in achieving intraoperative hemodynamic stability with minimal need for rescue agents and its analgesic effect postoperatively, if added to bupivacaine in fascia iliaca block. Results: Dexmedetomidine significantly maintained mean arterial blood pressure and heart rate (P-value <0.001); with lower intraoperative fentanyl consumption in group A (53.85 ± 13.87 µg) when compared to group B (150.00 ± 40.35 µg) and no significant difference between the two groups in VAS scores postoperatively. Conclusions: Dexmedetomidine infusion provided stable intraoperative hemodynamics in patients undergoing hip arthroscopy with reduced intraoperative narcotics requirement, while addition of dexmedetomidine to bupivacaine had no role in prolonging the effect of FICB.

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Section: Methodsmentioning

confidence: 99%

The efficacy of adding dexmedetomidine perineurally in fascia iliaca compartment block versus intravenously in hip arthroscopy: A randomized controlled trial

Ibrahim¹,

Elderh²,

Abdelsalam³

2023

Rev. chil. anest.

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Comparative study between the effect of dexmedetomidine and lidocaine infusion in lumbar fixation on hemodynamics, fentanyl requirements, and postoperative analgesia

Mohammed

Habib

Abbas

et al. 2020

Ain-Shams J Anesthesiol

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Background Spinal surgery is associated with high incidence of severe postoperative pain difficult to easy control. Appropriate treatment modalities decreased the postoperative morbidity, increased patient satisfaction, allowed early mobility, and decreased hospital costs. Lidocaine was used as intravenous additives to control intraoperative pain and decrease postoperative pain. As lidocaine, dexmedetomidine infusion associated with lower postoperative pain scores decreased the opioid consumption and its related adverse events. The aim of this double blind randomized prospective comparative study was to compare the efficacy of intraoperative dexmedetomidine versus lidocaine infusion on hemodynamics, fentanyl requirements, and postoperative analgesia among 66 patients subjected to lumbar fixation surgery and randomized into group D which received dexmedetomidine 1 μg/kg infusion over 10 min as a loading dose then 0.3–0.5 μg/kg/h after induction of anesthesia as maintenance dose and group X which received lidocaine 0.3–0.5 mg/kg/h after induction of anesthesia. Results At 10, 15, 30, and 60 min, the mean arterial blood pressure and heart rate significantly decreased in group D compared to group X, and there was significantly higher total dose of intraoperative analgesic for fentanyl in group X than group D. There was significantly higher numeric rating scale in group X compared to group D at 2, 4, 6, 9, 12, 18, and 24 h postoperative with significant early request of the first analgesia, higher incidence of analgesic needs, and higher dose of postoperative analgesia paracetamol, voltaren, or pethidine in group X compared to group D. Conclusions The intraoperative use of dexmedetomidine IV infusion was an alternative mode to decrease the demands of analgesia following spine surgery.

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Efficacy of Dexmedetomidine Infusion Without Loading Dose as a Potent Hypotensive Agent in Lumbar Fixation Surgery

Cited by 2 publications

References 13 publications

The efficacy of adding dexmedetomidine perineurally in fascia iliaca compartment block versus intravenously in hip arthroscopy: A randomized controlled trial

The efficacy of adding dexmedetomidine perineurally in fascia iliaca compartment block versus intravenously in hip arthroscopy: A randomized controlled trial

Comparative study between the effect of dexmedetomidine and lidocaine infusion in lumbar fixation on hemodynamics, fentanyl requirements, and postoperative analgesia

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