Anesth Pain Med.  2018 Jan;13(1):23-29. 10.17085/apm.2018.13.1.23.

Pre-anesthetic sedative effect of dexmedetomidine in laparoscopic cholecystectomy performed under general anesthesia

• Kim JW
• Lee HL
• Park JS
• Kim JH
• Ryu KH

• KMID: 2436051
• DOI: http://doi.org/10.17085/apm.2018.13.1.23

Abstract

BACKGROUND
This study evaluated the effects of pre-anesthetic administration of dexmedetomidine on sedative, cardiovascular, and recovery parameters.
METHODS
This was a prospective, randomized, double-blind, placebo-controlled study. We selected 60 patients who were scheduled to undergo laparoscopic cholecystectomy. They were randomly divided into two groups and received 0.5 µg/kg of dexmedetomidine (group D) or normal saline (group S) over 10 minutes before induction of anesthesia. The Ramsay sedation scale (RSS) score and bispectral index (BIS) were recorded after completion of the dexmedetomidine infusion. Mean arterial pressure (MAP), heart rate (HR), peripheral pulse oximetry, cardiac output (CO), and systemic vascular resistance (SVR) were recorded. The modified Aldrete recovery score (MARS) was recorded in the recovery room.
RESULTS
After completion of the dexmedetomidine infusion, BIS reduction was less than 20% (97.1 ± 2.4, 83.8 ± 4.8; P < 0.001), but RSS-rated sedation was appropriate (P < 0.001). HR was lowest at the end of the dexmedetomidine infusion and there was a significant difference between groups (P < 0.001); however, MAP was not significantly different between groups (P = 0.139). CO was lowest and SVR was highest at the end of the dexmedetomidine infusion. There was no significant difference in MARS values between groups (P = 0.190).
CONCLUSIONS
A pre-anesthetic dexmedetomidine (0.5 µg/kg) provided appropriate sedation without serious changes in cardiovascular parameters or a prolonged recovery time.

Keyword

Dexmedetomidine; Laparoscopic cholecystectomy; Moderate sedation

MeSH Terms

Anesthesia
Anesthesia, General*
Arterial Pressure
Cardiac Output
Cholecystectomy, Laparoscopic*
Conscious Sedation
Dexmedetomidine*
Heart Rate
Humans
Hypnotics and Sedatives*
Mars
Oximetry
Prospective Studies
Recovery Room
Vascular Resistance
Dexmedetomidine
Hypnotics and Sedatives

Figure

• 

  Fig. 1 Anesthesia protocol. T0: baseline, T10: completion of the dexmedetomidine (DEX) or saline infusion, T15: intubation, BIS: bispectral index, RSS: Ramsay sedation scale, ES: end of surgery, ET: extubation time.

• 

  Fig. 2 Changes in heart rate in the two groups. Group D: The group injected with 0.5 μg/kg of dexmedetomidine (DEX). Group S: The group injected with 0.9% normal saline. T0: baseline, T5: 5 minutes after DEX or saline infusion, T10: completion of the DEX or saline infusion, T15: intubation, ES: end of surgery, ET: extubation time. *Significant difference between the two groups (P = 0.017).

• 

  Fig. 3 Changes in mean arterial pressure (MAP) in group D. Group D: The group injected with 0.5 μg/kg of dexmedetomidine (DEX). Group S: The group injected with 0.9% normal saline. T0: baseline, T5: 5 minutes after DEX or saline infusion, T10: completion of the DEX or saline infusion, T15: intubation, ES: end of surgery, ET: extubation time. *Significant difference between the two groups (P < 0.017).

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