J Korean Assoc Oral Maxillofac Surg.  2019 Jun;45(3):152-157. 10.5125/jkaoms.2019.45.3.152.

Sedation with dexmedetomidine in elderly patients during dental surgery: a retrospective case series

• Seto M
• Kita R
• Kondo S

• KMID: 2451322
• DOI: http://doi.org/10.5125/jkaoms.2019.45.3.152

Abstract

OBJECTIVES
The number of elderly patients with systemic basal disease requiring invasive dental treatment has increased. Appropriate prediction of surgical invasiveness and combined use of psychosedation are thought to contribute to safe whole-body management. Dexmedetomidine (DEX) exhibits analgesic and anti-anxiolytic properties and causes mild respiratory depression. Studies regarding DEX use in elderly non-intubated patients are scarce. We aimed to use retrospective data to determine an effective dose of DEX to induce adequate sedation in elderly patients undergoing invasive dental surgery under local anesthesia.
MATERIALS AND METHODS
One hundred two patients aged 70 to 96 years were presumably appropriately controlled with sedation. DEX was administered at an initial loading dose of 2.0 to 3.1 µg/kg/hr for 10 minutes. We divided the patients into five groups by age and compared their blood pressures and heart rates.
RESULTS
In all five groups, blood pressure decreased suddenly at approximately 15 and 20 minutes after DEX administration. A marked decrease in blood pressure was noted in patients aged 75 to 79 years.
CONCLUSION
For elderly patients aged 75 years and above, the initial loading dose of DEX needs to be reduced to lower than half that required for young and middle-age adults.

Keyword

Dexmedetomidine; Sedation; Elderly

MeSH Terms

Adult
Aged*
Anesthesia, Local
Blood Group Antigens
Blood Pressure
Dexmedetomidine*
Heart Rate
Humans
Respiratory Insufficiency
Retrospective Studies*
Blood Group Antigens
Dexmedetomidine

Figure

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  Fig. 1 A, B. Transitional changes in mean blood pressure. (Admit: admission time, Pre-sedation: walking into the operating room, DEX IV: immediately before administration of dexmedetomidine, 5 min: 5 minutes after the administration of dexmedetomidine, 10 min: 10 minutes after the administration of dexmedetomidine, LA: immediately after infiltration anesthesia, 15 min: 15 minutes after the administration of dexmedetomidine, 20 min: 20 minutes after the administration of dexmedetomidine, 30 min: 30 minutes after the administration of dexmedetomidine, Discharge: immediately before returning to the ward)

• 

  Fig. 2 A, B. Transitional changes in heart rate. Refer to Fig. 1 for the definition of the abbreviations.

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