Korean J Anesthesiol.  2014 Oct;67(4):246-251. 10.4097/kjae.2014.67.4.246.

Laparoscopic appendectomy under spinal anesthesia with dexmedetomidine infusion

• Jun GW
• Kim MS
• Yang HJ
• Sung TY
• Park DH
• Cho CK
• Kwon HU
• Kang PS
• Moon JI

• KMID: 1937683
• DOI: http://doi.org/10.4097/kjae.2014.67.4.246

Abstract

BACKGROUND
Laparoscopic appendectomy (LA) is rarely performed under regional anesthesia because of pneumoperitoneum-related problems. We expected that dexmedetomidine would compensate for the problems arising from spinal anesthesia alone. Thus, we performed a feasibility study of spinal anesthesia with intravenous dexmedetomidine infusion.
METHODS
Twenty-six patients undergoing LA received spinal anesthesia with intravenous dexmedetomidine infusion. During surgery, the patient's pain or discomfort was controlled by supplemental fentanyl or ketamine injection, and all adverse effects were evaluated.
RESULTS
No patient required conversion to general anesthesia, and all operations were completed laparoscopically without conversion to open surgery. Seventeen (65.4%) patients required supplemental injection of fentanyl or ketamine. Bradycardia occurred in seven (26.9%) patients.
CONCLUSIONS
Spinal anesthesia with dexmedetomidine infusion may be feasible for LA. However, additional analgesia, sedation, and careful attention to the potential development of bradycardia are needed for a successful anesthetic outcome.

Keyword

Dexmedetomidine; Laparoscopic appendectomy; Spinal anesthesia

MeSH Terms

Analgesia
Anesthesia, Conduction
Anesthesia, General
Anesthesia, Spinal*
Appendectomy*
Bradycardia
Conversion to Open Surgery
Dexmedetomidine*
Feasibility Studies
Fentanyl
Humans
Ketamine
Dexmedetomidine
Fentanyl
Ketamine