Optimal dose of dexmedetomidine for attenuating cardiovascular response during emergence in patients undergoing total laparoscopic hysterectomy

Abstract

Objective: To investigate the optimal dose of dexmedetomidine for attenuating the haemodynamic response during emergence from anaesthesia. Methods: Patients undergoing laparoscopic total hysterectomy were randomly allocated to receive 0.9% normal saline (control group) or dexmedetomidine (0.5 mg/kg, 0.75 mg/kg or 1.0 mg/kg 30 min) before extubation. Heart rate, systolic and diastolic arterial pressure and extubation time were measured before drug administration, immediately after the end of drug administration, 10 min after the end of drug administration, immediately after extubation and 5 min after extubation. Results: A total of 120 patients were included in the study (30 per group). Systolic and diastolic arterial pressure and heart rate after drug administration were significantly lower in all three dexmedetomidine groups compared with controls. Extubation times in the 0.75 and 1.0 mg/kg dexmedetomidine groups were significantly longer than in the control group. Conclusion: Intravenous infusion of 0.5 mg/kg dexmedetomidine 30 min before the end of surgery attenuated the haemodynamic responses during emergence without prolonging the extubation time. Dexmedetomidine doses higher than 0.5 mg/kg did not exert additional positive effects on cardiovascular responses, but did significantly prolong the extubation time.

Effects of Dexmedetomidine on Intraoperative Hemodynamics, Recovery Profile and Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Controlled Trial

“…However, we found that the incidences of bradycardia in the groups dexmedetomidine 0.4ug/kg, 0.6ug/kg and 0.8ug/kg were 10.00%, 13.33% and 16.67% respectively, indicating that the incidence of bradycardia increased with the increase of dexmedetomidine dose. Seo KH et al also found that the incidences of bradycardia at 0.75ug/kg and 1ug/kg increased compared with that at 0.5ug/kg [15] , which was consistent with our nding. The occurrence of bradycardia is related to the inhibition of atrioventricular node and sinoatrial node function, reduction of catecholamine content in the blood and excitation of vagus nerve by dexmedetomidine [12,16] .…”

Effect of Dexmedetomidine in Preventing Postoperative Side Effects for Laparoscopic Surgery

“…8 Eight RCTs had >2 groups. 8,9,19,21,27–29,31 A total of 899 patients undergone laparoscopic surgeries were included in the meta-analysis. A total of 451 patients were administrated with DEX and 448 were with placebo or no treatment.…”

“…Six trials 9,20,21,23,25,29 including 360 patients compared extubation time in patients treated with DEX or control. No significance was observed between 2 groups (MD = 0.70, 95% CI: −0.89 to −2.28, P  = 0.39, I 2  = 98%) (Table 2).…”

Optimal dose of intravenous oxycodone for attenuating hemodynamic changes after endotracheal intubation in healthy patients

“…Intravenous administration of oxycodone can help modifying hemodynamic response to laryngoscopy and intubation during induction phase and can be an adjuvant drug to inhalation agents during maintenance period of general anesthesia. The optimal dose of fentanyl [3] or dexmedetomidine [8] for attenuating the hemodynamic changes during induction was investigated. However, the recommendations for the appropriate dosage of oxycodone, especially for intubation, are insufficient.…”