Pharmacokinetic and pharmacodynamics of intravenous dexmedetomidine in morbidly obese patients undergoing laparoscopic surgery

Xu, Bo; Zhou, Dongxu; Ren, Li; Shulman, Steven; Zhang, Xingan; Xiong, Ming

doi:10.1007/s00540-017-2399-y

Cited by 20 publications

(19 citation statements)

References 16 publications

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“…Shortcomings related to the study setting (i.e., operating room versus ICU) would apply. One study evaluated the pharmacokinetics of dexmedetomidine in morbidly obese patients undergoing laparoscopic surgery [52]. There was no difference in volume of distribution when normalized to ABW (2.48 ± 0.47 vs. 2.38 ± 0.72 L/kg; p = .72) but clearance was significantly lower with obesity (0.47 ± 0.07 vs. 0.64 ± 0.09 L/kg/h; p < .01, based on ABW).…”

Section: Dexmedetomidinementioning

confidence: 99%

Drug dosing in the critically ill obese patient—a focus on sedation, analgesia, and delirium

Erstad

Barletta

2020

Crit Care

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Practice guidelines provide clear evidence-based recommendations for the use of drug therapy to manage pain, agitation, and delirium associated with critical illness. Dosing recommendations however are often based on strategies used in patients with normal body habitus. Recommendations specific to critically ill patients with extreme obesity are lacking. Nonetheless, clinicians must craft dosing regimens for this population. This paper is intended to help clinicians design initial dosing regimens for medications commonly used in the management of pain, agitation, and delirium in critically ill patients with extreme obesity. A detailed literature search was conducted with an emphasis on obesity, pharmacokinetics, and dosing. Relevant manuscripts were reviewed and strategies for dosing are provided.

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Section: Dexmedetomidinementioning

confidence: 99%

Drug dosing in the critically ill obese patient—a focus on sedation, analgesia, and delirium

Erstad

Barletta

2020

Crit Care

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“…The infusion was discontinued when the laparoscopy ports were removed. The chosen loading and maintenance dexmedetomidine doses can be safely administered in MO patients as documented by previous studies [12,13].…”

Section: Anesthetic Techniquementioning

confidence: 85%

Effect of perioperative dexmedetomidine infusion on blood glucose levels in non-diabetic morbid obese patients undergoing laparoscopic bariatric surgery

Mostafa

Ibrahim

Ayoub

2018

Egyptian Journal of Anaesthesia

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“…Patients received 100% oxygen at a flow rate of 5 L min −1 via a mask during continuous administration of dexmedetomidine, which lasted 15 min and was completed 10 min before endotracheal intubation. 10 Target-controlled infusion (TCI) of propofol with a Graseby 3500 Anaesthesia Pump (Smiths Medical MD, Inc. USA) was used for anaesthesia induction. The targeted plasma concentration of propofol was set to 4 μg ml −1 and was maintained for at least 12 min before intubation.…”

Section: Methodsmentioning

confidence: 99%

A Response Surface Analysis of the Combination of Dexmedetomidine and Sufentanil for Attenuating the Haemodynamic Response to Endotracheal Intubation

Jia

et al. 2022

Dose-Response

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Purpose Dexmedetomidine combined with opioids has been extensively used to blunt cardiovascular responses to endotracheal intubation. To determine their interaction, we aimed to develop a response surface model between dexmedetomidine and sufentanil. Methods One hundred and twenty patients undergoing scheduled gynaecological surgery were recruited. According to a simulation of slice design, patients received different dose pairs of dexmedetomidine (0 to 1.1 μg/kg) and sufentanil (.1 to .5 μg/kg). The mean arterial blood pressure and heart rate of patients were recorded just before endotracheal intubation, immediately after intubation, and during the first 3 min after intubation. The primary outcomes were haemodynamic changes. The full dose–response relationship between dexmedetomidine and sufentanil was analysed using a logit model. Results This response surface model revealed that the interaction between dexmedetomidine and sufentanil was additive. The dose pairs that could effectively attenuate the haemodynamic response to endotracheal intubation primarily ranged from .3 to .4 μg/kg and .5 to 1.1 μg/kg for sufentanil and dexmedetomidine, respectively. Conclusion When used propofol as the main hypnotic drug during anaesthesia induction, dexmedetomidine could effectively reduce the requirement of sufentanil in an additive manner. However, it is not an effective drug for ablating the cardiovascular response to endotracheal intubation when used alone. The clinical trial registry. The trial registry name: Chinese Clinical Trial Registry. Registration number: ChiCTR1800015273. URL: http://www.chictr.org.cn

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Pharmacokinetic and pharmacodynamics of intravenous dexmedetomidine in morbidly obese patients undergoing laparoscopic surgery

Abstract: ClinicalTrials.gov (NCT01864187), https://register.clinicaltrials.gov/prs/app/action/LoginUser?ts=1&cx=-jg9qo4 .

Cited by 20 publications

References 16 publications

Drug dosing in the critically ill obese patient—a focus on sedation, analgesia, and delirium

Drug dosing in the critically ill obese patient—a focus on sedation, analgesia, and delirium

Effect of perioperative dexmedetomidine infusion on blood glucose levels in non-diabetic morbid obese patients undergoing laparoscopic bariatric surgery

A Response Surface Analysis of the Combination of Dexmedetomidine and Sufentanil for Attenuating the Haemodynamic Response to Endotracheal Intubation

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