Sedation in hypoalbuminemic geriatric patients under spinal anesthesia in hip surgery

Ersoy, Ayşın; Kara, Deniz; Ervatan, Zekeriya; Çakırgöz, Mensure Yılmaz; Kıran, Özlem

doi:10.15537/smj.2015.10.12403

Cited by 8 publications

(2 citation statements)

References 24 publications

(18 reference statements)

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“…This undesired outcome is eliminated by sedating the patients during the operation. Sedation is possible through inhalation or bolus or continuous infusion of pharmacological agents injected intravenously [10]. …”

Section: Discussionmentioning

confidence: 99%

Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation

Kılıç

Aydin²

2018

Libyan Journal of Medicine

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Background: We evaluated the effects of intravenous dexmedetomidine during spinal anesthesia on hemodynamics, respiratory rate, oxygen saturation, sedpain, and compared them with those of saline infusion. Sixty American Society of Anesthesiologists physical status I and II cases were randomly divided into two groups. Patients were connected to the monitor after premedication, and spinal anesthesia was administered. Sensory and motor blockades were assessed using pinprick test and Bromage scale, respectively. Group I received dexmedetomidine infusion and Group II received saline infusion. Throughout the infusion process, hemodynamic data, respiratory rate, oxygen saturation, sedation, pain, Bromage score, amnesia, bispectral index, and side effects were recorded. Postoperative hemodynamic measurements, oxygen saturation, sedation, pain scores were obtained. Sedation and pain were evaluated using the Ramsay and visual analog scales, respectively. Analgesics were administered in cases with high scores on the visual analog scale. Postoperative analgesic consumption, side effects, treatments were recorded. No significant differences were found between the groups with respect to oxygen saturation, respiratory rate, pain, and side effects in the intraoperative period. Time to onset of sensorial block, maximum sensorial block, onset of motor block, and maximum motor block; bispectral index values; and apex heartbeat until 80 min of infusion, systolic arterial blood pressure until 90 min, and diastolic arterial blood pressure until 50 min were lower, whereas amnesia and sedation levels were higher in dexmedetomidine group. Postoperative pain and analgesic requirement were not different. Apex heartbeat at 15 min and systolic arterial blood pressure at 30 min were lower and sedation scores were higher in the dexmedetomidine infusion group. We demonstrated dexmedetomidine infusion had a hemodynamic depressant effect intraoperatively whereas it had no significant effect on peripheral oxygen saturation, respiratory rate, visual analog scale scores, and side effects. Dexmedetomidine infusion enhanced motor and sensory blockade quality and induced amnesia and sedation.

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Section: Discussionmentioning

confidence: 99%

Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation

Kılıç

Aydin²

2018

Libyan Journal of Medicine

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“…Fewer hemodynamic changes in PCSNB cases when compared with CSA cases were also noted [91]. A 2015 prospective randomized study comparing midazolam with propofol sedation in hypoalbuminemia (albumin level below 3 g/dl) geriatric patients under SA found that when compared with midazolam, propofol is associated with greater hemodynamic stability, lesser respiratory depression, and faster recovery [92].…”

Section: Mode Of Anesthesiamentioning

confidence: 93%

Anesthetic management of geriatric patients

Lim

2020

Korean J Anesthesiol

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The number of elderly patients who frequently access health care services is increasing worldwide. While anesthesiologists are developing the expertise to care for these elderly patients, areas of concern remain. We conducted a comprehensive search of major international databases (PubMed, Embase, and Cochrane) and a Korean database (KoreaMed) to review preoperative considerations, intraoperative management, and postoperative problems when anesthetizing elderly patients. Preoperative preparation of elderly patients included functional assessment to identify preexisting cognitive impairment or cardiopulmonary reserve, depression, frailty, nutrition, polypharmacy, and anticoagulation issues. Intraoperative management included anesthetic mode and pharmacology, monitoring, intravenous fluid or transfusion management, lung-protective ventilation, and prevention of hypothermia. Postoperative checklists included perioperative analgesia, postoperative delirium and cognitive dysfunction, and other complications. A higher level of perioperative care was required for older surgical patients, as multiple chronic diseases often makes them prone to developing postoperative complications, including functional decline and loss of independence. Although the guiding evidence remains poor so far, elderly patients have to be provided optimal perioperative care through close interdisciplinary, interprofessional, and cross-sectional collaboration to minimize unwanted postoperative outcomes. Furthermore, along with adequate anesthetic care, well-planned postoperative care should begin immediately after surgery and extend until discharge.

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