Document Detail


Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation.
MedLine Citation:
PMID:  19464613     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Takayuki Kunisawa; Osamu Nagata; Michio Nagashima; Sayuri Mitamura; Megumi Ueno; Akihiro Suzuki; Osamu Takahata; Hiroshi Iwasaki
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  21     ISSN:  1873-4529     ISO Abbreviation:  J Clin Anesth     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  194-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan. taka.kunisawa@nifty.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Agonists / 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:
0/Adrenergic alpha-Agonists; 0/Anesthetics, Intravenous; 113775-47-6/Dexmedetomidine; 2078-54-8/Propofol; 437-38-7/Fentanyl

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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