Document Detail


Effect of epidural dexmedetomidine on intraoperative awareness and post-operative pain after one-lung ventilation.
MedLine Citation:
PMID:  20085547     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: During combined general and regional anaesthesia, it is difficult to use autonomic signs to assess whether wakefulness is suppressed adequately. We compared the effects of a dexmedetomidine-bupivacaine mixture with plain bupivacaine for thoracic epidural anaesthesia on intraoperative awareness and analgesic benefits, when combined with superficial isoflurane anaesthesia (<0.05 maximum alveolar concentration) in patients undergoing thoracic surgery with one-lung ventilation (OLV). METHODS: Fifty adult male patients were randomly assigned to receive either epidural dexmedetomidine 1 microg/kg with bupivacaine 0.5% (group D) or bupivacaine 0.5% alone (group B) after induction of general anaesthesia. Gasometric, haemodynamic and bispectral index values were recorded. Post-operative verbal rating score for pain and observer's assessment of alertness/sedation scale were determined by a blinded observer. RESULTS: Dexmedetomidine reduced the use of supplementary fentanyl during surgery. Patients in group B consumed more analgesics and had higher pain scores after operation than patients of group D. The level of sedation was similar between the two groups in the ICU. Two patients (8%) in group B reported possible intraoperative awareness. There was a limited decrease in PaO2 at OLV in group D compared with group B (P<0.05). CONCLUSION: In thoracic surgery with OLV, the use of epidural dexmedetomidine decreases the anaesthetic requirements significantly, prevents awareness during anaesthesia and improves intraoperative oxygenation and post-operative analgesia.
Authors:
M Elhakim; D Abdelhamid; H Abdelfattach; H Magdy; A Elsayed; M Elshafei
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2010-01-18
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  703-9     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Faculty of Medicine, Ain-Shams University, Cairo, Egypt. mokhtar.elhakim@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Agonists / administration & dosage,  pharmacology*,  therapeutic use
Adult
Analgesics, Non-Narcotic / administration & dosage,  pharmacology*,  therapeutic use
Anesthesia, Epidural*
Anesthesia, General
Anesthetics, Inhalation / administration & dosage,  adverse effects,  pharmacology
Anoxia / chemically induced,  prevention & control
Awareness / drug effects*
Bupivacaine / administration & dosage
Consciousness Monitors
Dexmedetomidine / administration & dosage,  pharmacology*,  therapeutic use
Hemodynamics / drug effects
Humans
Hypnotics and Sedatives / administration & dosage,  pharmacology*,  therapeutic use
Intraoperative Complications / epidemiology,  prevention & control*
Isoflurane / administration & dosage,  adverse effects,  pharmacology
Male
Middle Aged
Pain, Postoperative / drug therapy,  prevention & control*
Respiration, Artificial / methods*
Single-Blind Method
Thoracic Surgical Procedures
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 0/Analgesics, Non-Narcotic; 0/Anesthetics, Inhalation; 0/Hypnotics and Sedatives; 113775-47-6/Dexmedetomidine; 2180-92-9/Bupivacaine; 26675-46-7/Isoflurane

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


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