A loading dose of 1 µg/kg and maintenance dose of 0.5 µg/kg/h of dexmedetomidine for sedation under spinal anesthesia may induce excessive sedation and airway obstruction.
10.17085/apm.2016.11.3.255
- Author:
Jong Hoon YEOM
1
;
Mi Kyung OH
;
Dae Woong AHN
;
Soo In PARK
Author Information
1. Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea. yeomjh@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Bispectral index monitor;
Dexmedetomidine;
Ideal body weight;
Spinal anesthesia
- MeSH:
Airway Obstruction*;
Anesthesia, Spinal*;
Body Weight;
Capillaries;
Consciousness Monitors;
Cough;
Dexmedetomidine*;
Humans;
Ideal Body Weight;
Incidence;
Oxygen;
Vital Signs
- From:Anesthesia and Pain Medicine
2016;11(3):255-259
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: For many drugs, dosing scalars such as ideal body weight (IBW) and lean body mass are recommended over the use of total body weight (TBW) during weight-based dose calculations. Doses based on TBW are frequently used, and this may cause under- or over-dosing. Because dexmedetomidine (DEX) overdosing could increase the incidence of side effects, and spinal anesthesia may increase sensitivity to a sedative agent, determining an appropriate dose is critical. METHODS: Eighty patients were randomly divided into 2 groups, the IBW and TBW groups. Patients received a loading dose of DEX 1 µg/kg IBW or TBW for 10 min, followed by a continuous infusion at 0.5 µg/kg/h IBW or TBW after the induction of spinal anesthesia. The patients' vital signs, bispectral index (BIS), peripheral capillary oxygen saturation, time to reach a BIS of 80, airway obstruction score, and coughing were monitored and recorded at 0, 10, 30, and 50 min after the start of the loading dose injection. RESULTS: The changes in BIS, airway obstruction score, the incidence of side effects, and time to reach a BIS of 80 did not show statistically significant differences between the two groups. However, airway obstruction and/or coughing occurred in both groups, and the average BIS in both groups was lower than the target BIS of 60-80 at 30 and 50 min. CONCLUSIONS: A loading dose of DEX 1 µg/kg for 10 min, and a maintenance dose of DEX 0.5 µg/kg/h of either IBW or TBW, may induce excessive sedation, airway obstruction, and/or coughing under spinal anesthesia.
