| Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation. | |
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MedLine Citation:
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PMID: 19464613 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY OBJECTIVE: To evaluate the effect of dexmedetomidine combined with fentanyl on hemodynamics. DESIGN: Prospective, double-blinded, randomized study. SETTING: Operating room of a university hospital. PATIENTS: 30 ASA physical status II and III patients with mild-to-moderate cardiovascular disease. INTERVENTIONS: Patients were assigned to one of three groups: Group D-F2 [dexmedetomidine, effect-site concentration (ESC) of fentanyl = two ng/mL]; Group F2 (placebo, ESC of fentanyl = two ng/mL), or Group F4 (placebo, ESC of fentanyl = 4 ng/mL). MEASUREMENTS: Dexmedetomidine (an initial dose of 1.0 microg/kg for 10 min, followed by a continuous infusion of 0.7 microg x kg(-1) x hr(-1)) or placebo saline was administered 15 minutes before anesthetic induction. Anesthesia was induced with propofol and fentanyl using a target-controlled infusion system. Hemodynamic parameters: systolic (SBP) and diastolic blood pressures (DBP), and heart rate (HR) during anesthetic induction were measured and the percent changes were calculated for both induction and intubation. MAIN RESULTS: After inducing anesthesia, SBP was significantly higher in Group D-F2 (127 +/- 24 mmHg) than Group F2 (90 +/- 20 mmHg) or Group F4 (77 +/- 21 mmHg). The SBP in Groups F2 and F4 reached 160 +/- 31 mmHg and 123 +/- 36 mmHg, respectively, after intubation, but no significant change in SBP was noted in Group D-F2. The percent increase in SBP due to tracheal intubation in Group D-F2 was 3% +/- 4% and was significantly lower than that of Group F2 (70% +/- 34%) or Group F4 (45% +/- 36%). CONCLUSION: Dexmedetomidine combined with fentanyl during anesthetic induction suppresses the decrease in blood pressure due to anesthetic induction and also blunts the cardiovascular response to tracheal intubation. |
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Authors:
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Takayuki Kunisawa; Osamu Nagata; Michio Nagashima; Sayuri Mitamura; Megumi Ueno; Akihiro Suzuki; Osamu Takahata; Hiroshi Iwasaki |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of clinical anesthesia Volume: 21 ISSN: 1873-4529 ISO Abbreviation: J Clin Anesth Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-25 Completed Date: 2009-08-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8812166 Medline TA: J Clin Anesth Country: United States |
Other Details:
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Languages: eng Pagination: 194-9 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan. taka.kunisawa@nifty.ne.jp |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic alpha-Agonists
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pharmacology* Aged Aged, 80 and over Anesthetics, Intravenous / administration & dosage, adverse effects* Blood Pressure / drug effects Cardiovascular Diseases / surgery Cardiovascular Surgical Procedures / methods Dexmedetomidine / pharmacology* Dose-Response Relationship, Drug Double-Blind Method Female Fentanyl / administration & dosage, adverse effects* Heart Rate / drug effects Humans Intubation, Intratracheal / adverse effects Male Middle Aged Pilot Projects Propofol / administration & dosage Prospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic alpha-Agonists; 0/Anesthetics, Intravenous; 113775-47-6/Dexmedetomidine; 2078-54-8/Propofol; 437-38-7/Fentanyl |
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