Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia

Kaya, Fatma Nur; Yavaşçaoğlu, Belgin; Türker, Gürkan; Yıldırım, Arzu Birinci; Gurbet, Alp; Moğol, Elif Başağan; Özcan, Berin

doi:10.1007/s12630-009-9231-6

Cited by 123 publications

(179 citation statements)

References 23 publications

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“…Few study have reported intravenous dexmedetomidine shortened the onset time by 30-60 sec, which might be clinically significant but it was insignificant statistically [11,33,35].…”

Section: Onset Of Sensory/motor Blockadementioning

confidence: 96%

“…The timing and dosing method of intravenous dexmedetomidine in spinal anaesthesia varies in different study. Commonly used method of intravenous dexmedetomidine is either as loading dose just before or after spinal anaesthesia [12,[27][28][29][30][31][32], loading dose followed by continuous infusion [11,[33][34][35][36]. Most commonly used loading dose is 0.5 mcg/kg to 1 mcg/kg over 10 min and infusion dose range from 0.2 mcg/kg/hr to 1 mcg/kg/hr [25,26].…”

Section: Intravenous Dexmedetomidine and Spinal Anaesthesiamentioning

confidence: 99%

“…Some studies have reported higher level of sensory-motor blockade of hyperbaric bupivacaine by the use intravenous dexmedetomidine [30,31,33,35,43] whereas, in study using low dose intravenous dexmedetomidine as sedative agent after spinal anaesthesia reported no difference in block characteristic by dexmedetomidine [36]. Lee et al [12] using two different dose of dexmedetomidine (0.5 mcg/kg Vs 1 mcg/kg) reported higher level of sensory block in both group of dexmedetomidine in comparison to placebo.…”

Section: Block Heightmentioning

confidence: 99%

“…Sensory block duration -though there are too much variation in method and dose of intravenous dexmedetomidine and duration of sensory blockadebut most of the studies has reported significantly increased duration of sensory blockade by use of intravenous dexmedetomidine [11][12][13][28][29][30][31][32][33][34][35]37,38,42]. Only one study did not find any difference in block quality with the use of low dose dexmedetomidine infusion that was used solely for the purpose of intraoperative sedation [36].…”

Section: Duration Of Blockmentioning

confidence: 99%

See 3 more Smart Citations

Role of Intravenous Dexmedetomidine in Prolonging Postoperative Analgesia and Quality of Block Following Spinal Anaesthesia. A Systemic Review and Update

Upadhyay¹,

Samanth²,

Tellicherry³

et al. 2015

J Pain Relief

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“…Few study have reported intravenous dexmedetomidine shortened the onset time by 30-60 sec, which might be clinically significant but it was insignificant statistically [11,33,35].…”

Section: Onset Of Sensory/motor Blockadementioning

confidence: 96%

Section: Intravenous Dexmedetomidine and Spinal Anaesthesiamentioning

confidence: 99%

Section: Block Heightmentioning

confidence: 99%

Section: Duration Of Blockmentioning

confidence: 99%

See 2 more Smart Citations

Role of Intravenous Dexmedetomidine in Prolonging Postoperative Analgesia and Quality of Block Following Spinal Anaesthesia. A Systemic Review and Update

Upadhyay¹,

Samanth²,

Tellicherry³

et al. 2015

J Pain Relief

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“…8,9 The use of intravenous dexmedetomidine for sedation during spinal anesthesia has been studied to some extent, evidenced by its prolonging effect on the duration of sensory and motor block. 10 A delayed time to first analgesic request was observed in patients undergoing transurethral prostatic resection with spinal anesthesia. 11 Despite the significant decreases seen following general anesthesia, there is a lack of randomized-controlled trials (RCTs) studying the effects of dexmedetomidine on opioid consumption after spinal anesthesia.…”

Section: Résumémentioning

confidence: 99%

Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trial

Chan

Maslany

Gorman

et al. 2016

Can J Anesth/J Can Anesth

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Background It remains unclear whether the opioidsparing effects of dexmedetomidine seen in patients undergoing general anesthesia are reproducible in patients undergoing spinal anesthesia. We hypothesized that the administration of intravenous dexmedetomidine for sedation during total knee arthroplasty under spinal anesthesia would decrease postoperative morphine consumption in the first 24 hr following surgery. Methods We conducted this prospective double-blind randomized-controlled trial in 40 patients (American Society of Anesthesiologists physical status I-III) undergoing total knee arthroplasty with a standardized spinal anesthetic. Patients were randomized to receive either a dexmedetomidine loading dose of 0.5 lgÁkg -1 over ten minutes, followed by an infusion of 0.5 lgÁkgÁhr -1 for the duration of the surgery, or a normal saline loading dose and an infusion of an equivalent volume. The primary outcome was the consumption of morphine delivered via patientcontrolled analgesia in the first 24 hr following surgery. Results The mean (SD) cumulative morphine at 24 hr in the dexmedetomidine group was 29.2 (11.2) mg compared with 61.2 (17.2) mg in the placebo group (mean difference, 32.0 mg; 95% confidence interval, 22.7 to 41.2; P \ 0.001). In the dexmedetomidine group, there was a delay in the time to first analgesic request (P = 0.003) and a reduction in the mean morphine use at six and 12 hr following surgery (both P \ 0.001).Conclusions Dexmedetomidine was associated with a significant decrease in morphine use in the first 24 hr following total knee arthroplasty. Our study shows that an intraoperative infusion of dexmedetomidine for sedation in patients receiving spinal anesthesia can produce postoperative analgesic effects. This offers another potential adjunct in the multimodal pain management of these patients. This trial was registered at ClinicalTrials.gov (identifier NCT02026141).

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Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery

Duncan

Sankar

Beattie

et al. 2018

Cochrane Database of Systematic Reviews

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Our review concludes that prophylactic α-2 adrenergic agonists generally do not prevent perioperative death or major cardiac complications. For non-cardiac surgery, there is moderate-to-high quality evidence that these agents do not prevent death, myocardial infarction or stroke. Conversely, there is moderate quality evidence that these agents have important adverse effects, namely increased risks of hypotension and bradycardia. For cardiac surgery, there is moderate quality evidence that α-2 adrenergic agonists have no effect on the risk of mortality or myocardial infarction, and that they increase the risk of bradycardia. The quality of evidence was inadequate to draw conclusions regarding the effects of alpha-2 agonists on stroke or hypotension during cardiac surgery.

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Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia

Cited by 123 publications

References 23 publications

Role of Intravenous Dexmedetomidine in Prolonging Postoperative Analgesia and Quality of Block Following Spinal Anaesthesia. A Systemic Review and Update

Role of Intravenous Dexmedetomidine in Prolonging Postoperative Analgesia and Quality of Block Following Spinal Anaesthesia. A Systemic Review and Update

Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trial

Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery

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