Korean J Anesthesiol.  2013 May;64(5):426-431. 10.4097/kjae.2013.64.5.426.

Optimal dose of dexmedetomidine for sedation during spinal anesthesia

• Ok HG
• Baek SH
• Baik SW
• Kim HK
• Shin SW
• Kim KH

• KMID: 1424905
• DOI: http://doi.org/10.4097/kjae.2013.64.5.426

Abstract

BACKGROUND
Sedation in spinal anesthesia can reduce patient's anxiety and discomfort. Dexmedetomidine has a sedative, hypnotic, analgesic, and minimal respiratory depression effect. However, use of the dexmedetomidine is associated with prolonged recovery. This study was designed to investigate the optimal dose of intravenous dexmedetomidine for proper sedation with minimal recovery time in spinal anesthesia.
METHODS
One hundred twenty eight patients, aged 20-70 years (58.8 +/- 0.7), were recruited. After performing the spinal anesthesia with hyperbaric bupivacaine (13 mg), a loading dose of dexmedetomidine (1 microg/kg) was administered for 10 min, followed by the maintenance infusion of the following: Group A (n = 33; normal saline), Group B (n = 35; dexmedetomidine 0.2 microg/kg/hr), and Group C (n = 39; dexmedetomidine 0.4 microg/kg/hr). Heart rate, blood pressure, and the bispectral index score (BIS) were recorded during the operation. In the recovery room, modified aldrete score (MAS) was measured.
RESULTS
There were no significant differences in mean blood pressure and heart rate among the three groups. BIS was not significantly different among the three groups from baseline to 60 min after the infusion of dexmedetomidine. BIS were significantly increased in Group A after 70 and 80 min, and Group A and B after 90, 100, 110 min of dexmedetomidine infusion (P < 0.05). MAS was higher in Group A as compared to Group B and C, within 30 min after admission in the recovery room (P < 0.05).
CONCLUSIONS
The loading dose (1 microg/kg/10 min) of dexmedetomidine was sufficient for surgery of less than 60 min. Dexmedetomidine infusion followed by maintenance dose (0.2 microg/kg/hr) was sufficient for surgery within 90 min.

Keyword

Dexmedetomidine; Sedation; Spinal anesthesia

MeSH Terms

Aged
Anesthesia, Spinal
Anxiety
Blood Pressure
Bupivacaine
Dexmedetomidine
Heart Rate
Humans
Recovery Room
Respiratory Insufficiency
Bupivacaine
Dexmedetomidine