J Korean Med Sci.  2016 Jan;31(1):125-130. 10.3346/jkms.2016.31.1.125.

Effects of Dexmedetomidine Infusion on the Recovery Profiles of Patients Undergoing Transurethral Resection

• Kwon SY
• Joo JD
• Cheon GY
• Oh HS
• In JH

• KMID: 2360002
• DOI: http://doi.org/10.3346/jkms.2016.31.1.125

Abstract

Transurethral resection has been the gold standard in the operative management of benign prostatic hyperplasia and bladder tumor; however, it is associated with several complications that may cause patient discomfort. We evaluated the usefulness of continuous infusion of dexmedetomidine on emergence agitation, hemodynamic status, and recovery profiles in patients undergoing elective surgery by a randomized clinical trial. Sixty patients aged 30 to 80 yr who were scheduled for elective transurethral resection under general anesthesia were included in this study. Participants were randomly assigned to two groups (control group, group C; dexmedetomidine group, group D). A total of 60 male patients were enrolled in this study and randomly assigned to group C (n=30) or group D (n=30). The quality of emergence in group D was marked by a significantly lower incidence of emergence agitation than in group C (P=0.015). Patients in group D therefore felt less discomfort induced by the indwelling Foley catheter than those in group C (P=0.022). No statistically significant differences were found between the two groups with respect to side effects including bradycardia (P=0.085), hypotension (P=0.640), and postoperative nausea and vomiting (P=0.389). Our study showed that intraoperative dexmedetomidine infusion effectively reduced the incidence and intensity of emergence agitation and catheter-induced bladder discomfort without delaying recovery time and discharge time, thus providing smooth emergence during the recovery period in patients undergoing transurethral resection (Clinical Trial Registry No. KT0001683).

Keyword

Anesthesia Recovery Period; Dexmedetomidine; Postoperative Nausea and Vomiting; Transurethral Resection

MeSH Terms

Adult
Aged
Aged, 80 and over
Blood Pressure
Bradycardia/etiology
Dexmedetomidine/adverse effects/*therapeutic use
Hemodynamics
Humans
Hypnotics and Sedatives/adverse effects/*therapeutic use
Hypotension/etiology
Male
Middle Aged
Nausea/etiology
Prostatic Hyperplasia/*surgery
Psychomotor Agitation/*drug therapy
*Transurethral Resection of Prostate
Vomiting/etiology
Dexmedetomidine
Hypnotics and Sedatives

Figure

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  Fig. 1 The incidence of emergence agitation. Group D, dexmedetomidine group; Group C, control group. An agitation score greater than 3 points was defined as agitation. P<0.05 compared to group C.

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  Fig. 2 Distribution of agitation scores. Group D, dexmedetomidine group; Group C, control group. Agitation score: 1=calm, 2=slightly agitated but consolable, 3=moderately agitated and inconsolable, 4=severely agitated and highly inconsolable.

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  Fig. 3 Intensity of discomfort. Group D, dexmedetomidine group; Group C, control group. Discomfort intensity: 1=comfortable, 2=uncomfortable but bearable, 3=severely uncomfortable. Catheter-induced bladder discomfort was significantly less intense in group D than in group C (P<0.05).

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  Fig. 4 Perioperative changes of hemodynamic variables. (A) Systolic blood pressure. (B) Diastolic blood pressure. (C) Heart rate. Group D, dexmedetomidine group; Group C, control group; T1, baseline; T2, induction of anesthesia; T3, beginning of surgery; T4, discontinuation of anesthetics; P1, arrival at post-anesthetic care unit (PACU); P2, 10 min after arrival at PACU; P3, 20 min after arrival at PACU. *P<0.05 compared to group C. Overall hemodynamic changes over time demonstrated significantly lower systolic and diastolic blood pressures and heart rate in group D compared to group C (P values are in the order of <0.001, 0.001, 0.005).

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