The effect of dexmedetomidine on the adjuvant propofol requirement and intraoperative hemodynamics during remifentanil-based anesthesia.
10.4097/kjae.2012.62.2.113
- Author:
Woon Seok KANG
1
;
Sung Yun KIM
;
Jong Chan SON
;
Ju Deok KIM
;
Hasmizy Bin MUHAMMAD
;
Seong Hyop KIM
;
Tae Gyoon YOON
;
Tae Yop KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea. pondkim@unitel.co.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Dexmedetomidine;
Propofol;
Remifentanil
- MeSH:
Airway Extubation;
Anesthesia;
Arterial Pressure;
Breast;
Dexmedetomidine;
Heart Rate;
Hemodynamics;
Humans;
Intubation;
Piperidines;
Propofol
- From:Korean Journal of Anesthesiology
2012;62(2):113-118
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The effects of dexmedetomidine on the propofol-sparing effect and intraoperative hemodynamics during remifentanil-based propofol-supplemented anesthesia have not been well investigated. METHODS: Twenty patients undergoing breast surgery were randomly allocated to receive dexmedetomidine (group DEX) or placebo (group C). In the DEX group, dexmedetomidine was loaded (1 microg/kg) before anesthesia induction and was infused (0.6 microg/kg/h) during surgery. Anesthesia was induced with a target-controlled infusion (TCI) of propofol (effect site concentration, Ce; 3 microg/ml) and remifentanil (plasma concentration, Cp, 10 ng/ml). The Ce of TCI-propofol was adjusted to a bispectral index of 45-55, and Cp of TCI-remifentanil was fixed at 10 ng/ml in both groups. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded at baseline (T-control), after the loading of study drugs (T-loading), 3 min after anesthesia induction (T-induction), tracheal intubation (T-trachea), incision (T-incision), 30 min after incision (T-incision30), and at tracheal extubation (T-extubation). MAP% and HR% (MAP and HR vs. T-control) were determined and the propofol infusion rate was calculated. RESULTS: The propofol infusion rate was significantly lower in the DEX group than in group C (63.9 +/- 16.2 vs. 96.4 +/- 10.0 microg/kg/min, respectively; P < 0.001). The changes in MAP% at T-induction, T-trachea and T-incision in group DEX (-10.0 +/- 3.9%, -9.4 +/- 4.6% and -11.2 +/- 6.3%, respectively) were significantly less than those in group C (-27.6 +/- 13.9%, -21.7 +/- 17.1%, and -25.1 +/- 14.1%; P < 0.05, respectively). CONCLUSIONS: Dexmedetomidine reduced the propofol requirement for remifentanil-based anesthesia while producing more stable intraoperative hemodynamics.
