The effect of dexmedetomidine continuous infusion as an adjuvant to general anesthesia on sevoflurane requirements: A study based on entropy analysis

Abstract

Background:Dexmedetomidine, a α2 agonist as an adjuvant in general anesthesia, has anesthetic and analgesic-sparing property.Aims:To evaluate the effect of continuous infusion of dexmedetomidine alone, without use of opioids, on requirement of sevoflurane during general anesthesia with continuous monitoring of depth of anesthesia by entropy analysis.Materials and Methods:Sixty patients were randomly divided into 2 groups of 30 each. In group A, fentanyl 2 mcg/kg was given while in group B, dexmedetomidine was given intravenously as loading dose of 1 mcg/kg over 10 min prior to induction. After induction with thiopentone in group B, dexmedetomidine was given as infusion at a dose of 0.2-0.8 mcg/kg. Sevoflurane was used as inhalation agent in both groups. Hemodynamic variables, sevoflurane inspired fraction (FIsevo), sevoflurane expired fraction (ETsevo), and entropy (Response entropy and state entropy) were continuously recorded. Statistical analysis was done by unpaired student's t-test and Chi-square test for continuous and categorical variables, respectively. A P-value < 0.05 was considered significant.Results:The use of dexmedetomidine with sevoflurane was associated with a statistical significant decrease in ETsevo at 5 minutes post-intubation (1.49 ± 0.11) and 60 minutes post-intubation (1.11 ±0.28) as compared to the group A [1.73 ±0.30 (5 minutes); 1.68 ±0.50 (60 minutes)]. There was an average 21.5% decrease in ETsevo in group B as compared to group A.Conclusions:Dexmedetomidine, as an adjuvant in general anesthesia, decreases requirement of sevoflurane for maintaining adequate depth of anesthesia.

Comparison of dexmedetomidine-propofol versus fentanyl-propofol for insertion of laryngeal mask airway

“…Dexmedetomidine also causes a reduction in doses of propofol both during induction and maintenance. [ 2 4 5 6 7 ]…”

The Effects of Dexmedetomidine or Remifentanil Continuous Infusion on End- Tidal Sevoflurane Concentration in Patients Undergoing Laparoscopic Cholecestectomies, Monitored by Bispectral Analysis

“…statistically significant hypotension and bradycardia was reported by Patel et al [23] in patients received dexmedetomidine throughout the intraoperative period with partial blunting of response to intubation and reduction of sevoflurane consumption. While group R showed no significant changes all over the surgery in the hemodynamics.…”

“…Patel et al [23] in their study observed that postoperatively dexmedetomidine group showed a significant sedation at 2 h compared to control group. Shin et al reported similar findings [15].…”

Dexmeditomodine as Anaesthetic Adjuvant to Relieve Stress Response in Gynecological Laparoscopic Surgeries

“…Thus they concluded that Dexmedetomidine is better additive in general anaesthesia when compared to fentanyl because of its multiple actions. [23] Claimed advantages of Dexmedetomidine include minimal respiratory depression with cardioprotection by ensuring hemodynamic stability, neuro-protection and renal protection by decreasing concentration of inhaled anaesthetic, muscle relaxants and opioids used for the procedure, thus making it useful at various situations including offsite procedures. Bradycardia and hypotension are the major side effects observed following Dexmedetomidine infusion.…”