Preanesthetic dexmedetomidine 1 µg/kg single infusion is a simple, easy, and economic adjuvant for general anesthesia

Abstract

Background: Dexmedetomidine is an α2-adrenoreceptor agonist with sedative, analgesic and anxiolytic effects, and it has more selective α2-adrenergic effect than clonidine. We evaluate the effect of preansethetic dexmedetomidine 1 µg/kg single infusion on sedation, hemodynamics, anesthetic consumption, and recovery profiles during anesthesia.

Methods: Forty-two female patients with American Society of Anesthesiologists physical status I or II undergoing gynecologic surgery with anticipated operation time of 2 h, were randomly assigned to receive dexmedetomidine 1 µg/kg (Dex group) or saline (control group) iv over 10 min before anesthetic induction. After tracheal intubation with propofol 2 mg/kg, cisatracurium 0.15 mg/kg iv, anesthesia was maintained with sevoflurane, O2 50%, N2O 50% around a BIS value of 40.

Results: After study drug infusion, BIS of Dex group was lower than that of control group (93.9 ± 3.1 vs 51.5 ± 5.2, P < 0.05). Mean arterial pressure (MAP) and heart rate (HR) after intubation were increased in control group, but did not change in Dex group. During maintenance, there was no difference in MAP between groups, but HR of Dex group was lower compared to that of control group. End-tidal concentration (2.0 ± 0.5 vol% vs 1.4 ± 0.3 vol%, P < 0.05) and total cumulative consumption of sevoflurane (34.6 ± 3.8 ml vs 26.5 ± 5.3 ml, P < 0.05) were lower in Dex group than in control group. Recovery profiles, modified Aldrete score, postoperative nausea vomiting, and visual analogue pain score were not significantly different between groups.

Conclusions: Preanesthetic dexmetomidine 1 µg/kg single infusion is a simple, easy, and economic general anesthetic adjuvant that maintains stable hemodynamics and decrease anesthetic consumption without the change of recovery profiles.

Keywords: Dexmedetomidine; Economics; Hemodynamics; Recovery of function; Sevoflurane.

Fig. 1

Changes in the Bispectral index (BIS) during sevoflruane anesthesia. ^*P < 0.05 compared with control group, ^†P < 0.05 compared with the value before induction, ^‡P < 0.05 compared with the value at the end of study drug infusion.

Fig. 2

Changes in (A) heart rate and (B) mean arterial pressure (MAP) during sevoflurane anesthesia. ^*P < 0.05 compared with control group, ^†P < 0.05 compared with the value before induction, ^‡P < 0.05 compared with the value at the end of study drug infusion.

Fig. 3

Changes in (A) the endtidal concentration of sevoflurane and (B) total cumulative consumption of sevoflurane (mean ± SD) during sevoflurane anesthesia. ^*P < 0.05 compared with control group.