KMID : 0356920120620020113
|
|
Korean Journal of Anesthesiology 2012 Volume.62 No. 2 p.113 ~ p.118
|
|
The effect of dexmedetomidine on the adjuvant propofol requirement and intraoperative hemodynamics during remifentanil-based anesthesia
|
|
Kang Woon-Seok
Kim Sung-Yun Son Jong-Chan Kim Ju-Deok Muhammad Hasmizy Bin Kim Seong-Hyop Yoon Tae-Gyoon Kim Tae-Yop
|
|
Abstract
|
|
|
Background: The effects of dexmedetomidine on the propofol-sparing effect and intraoperative hemodynamics during remifentanil-based propofol-supplemented anesthesia have not been well investigated.
Methods: Twenty patients undergoing breast surgery were randomly allocated to receive dexmedetomidine (group DEX) or placebo (group C). In the DEX group, dexmedetomidine was loaded (1 ¥ìg/kg) before anesthesia induction and was infused (0.6 ¥ìg/kg/h) during surgery. Anesthesia was induced with a target-controlled infusion (TCI) of propofol (effect site concentration, Ce; 3 ¥ìg/ml) and remifentanil (plasma concentration, Cp, 10 ng/ml). The Ce of TCI-propofol was adjusted to a bispectral index of 45-55, and Cp of TCI-remifentanil was fixed at 10 ng/ml in both groups. Mean arterial blood pressure (MAP) and heart rate (HR) were recorded at baseline (T-control), after the loading of study drugs (T-loading), 3 min after anesthesia induction (T-induction), tracheal intubation (T-trachea), incision (T-incision), 30 min after incision (T-incision30), and at tracheal extubation (T-extubation). MAP% and HR% (MAP and HR vs. T-control) were determined and the propofol infusion rate was calculated.
Results: The propofol infusion rate was significantly lower in the DEX group than in group C (63.9 ¡¾ 16.2 vs. 96.4 ¡¾ 10.0 ¥ìg/kg/min, respectively; P < 0.001). The changes in MAP% at T-induction, T-trachea and T-incision in group DEX (-10.0 ¡¾ 3.9%, -9.4 ¡¾ 4.6% and -11.2 ¡¾ 6.3%, respectively) were significantly less than those in group C (-27.6 ¡¾ 13.9%, -21.7 ¡¾ 17.1%, and -25.1 ¡¾ 14.1%; P < 0.05, respectively).
Conclusions: Dexmedetomidine reduced the propofol requirement for remifentanil-based anesthesia while producing more stable intraoperative hemodynamics.
|
|
KEYWORD
|
|
Dexmedetomidine, Propofol, Remifentanil
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|