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. 2014 Mar;58(2):154-9.
doi: 10.4103/0019-5049.130816.

Dexmedetomidine ameliorates monitored anaesthesia care

Priyamvada Gupta  1 , Samrat Joshi  1 , Durga Jethava  1 , Ankit Kumar  1
Affiliations

Dexmedetomidine ameliorates monitored anaesthesia care

Priyamvada Gupta et al. Indian J Anaesth. 2014 Mar.

Abstract

Background and aims: Monitored anaesthesia care (MAC) is meant for procedures under local anaesthesia. Various drugs have been used for this purpose. The recently introduced alpha2 agonist, dexmedetomidine provides "conscious sedation" with adequate analgesia and minimal respiratory depression. Hence, the safety and efficacy of two doses of dexmedetomidine for sedation and analgesia were evaluated.

Methods: A total of 90 patients were distributed in three groups of 30 each: Dexmedetomidine 0.5 μg/kg (DL), dexmedetomidine 1.0 μg/kg (DH) and normal saline (C). The initial loading dose was followed by maintenance infusion of 0.2-0.7 μg/kg/h of dexmedetomidine or equivalent volume of saline. Study drug was started at least 15 min before placement of local anaesthesia. Drugs were titrated to a target level of sedation (=3 on Ramsay sedation scale [RSS]). Midazolam 0.02 mg/kg for RSS < 3 and fentanyl 0.5 μg/kg were supplemented as required. The statistical analysis was performed using Chi-square test and mean and anova analysis.

Results: In groups DL and DH fewer patients required supplemental midazolam, 56.7% (17/30) and 40% (12/30), compared with control, where 86.7% (26/30)needed midazolam supplements. P = 0.000. Both groups DL and DH required significantly less fentanyl (84.8 and 83.9 μg) versus control (144.2 μg). There was significantly increased ease of achieving and maintaining targeted sedation and analgesia in both dexmedetomidine groups when compared with placebo (P = 0.001). Adverse events observed with dexmedetomidine were bradycardia and hypotension.

Conclusions: Dexmedetomidine in the doses studied was considered safe and effective sedative and analgesic for patients undergoing procedures under MAC.

Keywords: Conscious sedation; dexmedetomidine; monitored anaesthesia care; respiratory depression.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1a
Figure 1a
Number of patients requiring midazolam
Figure 1b
Figure 1b
Number of patients requiring fentanyl
Figure 2a
Figure 2a
Ramsay sedation scores in three groups
Figure 2b
Figure 2b
VAS for Pain in three groups
Figure 3a
Figure 3a
RSS In PACU in three groups
Figure 3b
Figure 3b
VAS In PACU in three groups
See this image and copyright information in PMC

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