Document Detail


Dexmedetomidine: an alternative for epidural anesthesia in tension-free vaginal-tape surgery.
MedLine Citation:
PMID:  21416311     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Anesthetic management of tension-free vaginal-tape (TVT) procedures is sometimes difficult to deal with, especially when surgeons request a cough test. Dexmedetomidine has unique sedative and analgesic properties while having minimal respiratory effects, making it suitable for perioperative use in monitored anesthesia care. We aimed to compare dexmedetomidine and epidural anesthesia in TVT patients. METHODS: Forty-nine women [American Society of Anesthesiologists (ASA 1-3)] with genuine stress incontinence confirmed by preoperative bladder function studies were included in this double-blind, randomized study. The patients were randomly assigned to one of two groups: group D received 0.5 μg/kg dexmedetomidine IV applied as bolus over 10 min and continued with 0.5 μg/kg/h infusion, and local anesthesia (lidocaine 2% with epinephrine) performed by the surgeon. Group E received epidural anesthesia with 15 ml of 0.25% bupivacaine + 100 μg fentanyl. Patients were monitored every 5 min for mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation, respiratory rate, sedation, and intraoperative and postoperative pain. Ability to cough was also evaluated by the surgeon. RESULTS: There was no difference in ability to cough, and this was evaluated by the surgeon as adequate, and there was no difference in scores between groups. Significant decreases in MAP and HR were observed 10 min after the start of surgery in group D compared with group E, and they were significantly decreased until first and second postoperative hours, respectively (p < 0.05). None of the patients had respiratory rate decrease or apnea. Side effects encountered postoperatively were similar. CONCLUSION: Dexmedetomidine can be an alternative to epidural anesthesia in TVT procedure requiring cough test.
Authors:
Alparslan Turan; Hüseyin Sen; Ali Sızlan; Omer Yanarateş; Sezai Ozkan; Onur Koyuncu; Güner Dağli
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-17
Journal Detail:
Title:  Journal of anesthesia     Volume:  -     ISSN:  1438-8359     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
The Cleveland Clinic, 9500 Euclid Avenue, P-77, Department of Outcomes Research, Anesthesiology Institute, Cleveland, OH, 44195, USA, turana@ccf.org.
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