Ghali Ashraf, Mahfouz Abdul Kader, Ihanamäki Tapio, El Btarny Ashraf M
Department of Anaesthesiology, Magrabi Eye & Ear Hospital, Muscat, Sultanate of Oman.
Saudi J Anaesth. 2011 Jan;5(1):36-41. doi: 10.4103/1658-354X.76506.
The purpose of this study was to evaluate the hemodynamic, respiratory effects, the recovery profile, surgeons, and patients satisfaction with dexmedetomidine sedation compared with those of propofol sedation in patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia.
Sixty patients were enrolled in this prospective, single-blind, randomized study. The patients were divided into two groups to receive either dexmedetomidine (group D) or propofol (group P). Sedation level was titrated to a Ramsay sedation scale (RSS) of 3. Hemodynamic and respiratory effects, postoperative recovery time, analgesic effects, surgeons and patients satisfaction were assessed.
Both groups provided a similar significant reduction in heart rate and mean arterial pressure compared with baseline values. The respiratory rate values of the dexmedetomidine group were significantly higher than those in the propofol group. The oxygen saturation values of the dexmedetomidine group were significantly higher than those of the propofol group. The expired CO(2) was similar in both groups. Postoperatively, the time to achieve an Aldrete score of 10 was similar in both groups. Dexmedetomidine patients have significantly lower visual analog scale for pain than propofol patients. The surgeon satisfaction with patients' sedation was similar for both groups. The patients' satisfaction was higher in the dexmedetomidine group.
Dexmedetomidine at similar sedation levels with propofol was associated with equivalent hemodynamic effects, maintaining an adequate respiratory function, similar time of discharge from PACU, better analgesic properties, similar surgeon's satisfaction, and higher patient's satisfaction. Thus, dexmedetomidine may prove to be a valuable adjuvant for sedation in patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia.
本研究旨在评估在球后麻醉下行玻璃体视网膜手术的患者中，与丙泊酚镇静相比，右美托咪定镇静的血流动力学、呼吸效应、恢复情况、外科医生及患者满意度。
60例患者纳入这项前瞻性、单盲、随机研究。患者被分为两组，分别接受右美托咪定（D组）或丙泊酚（P组）。镇静水平滴定至拉姆齐镇静评分（RSS）为3级。评估血流动力学和呼吸效应、术后恢复时间、镇痛效果、外科医生及患者满意度。
与基线值相比，两组心率和平均动脉压均显著降低。右美托咪定组的呼吸频率值显著高于丙泊酚组。右美托咪定组的血氧饱和度值显著高于丙泊酚组。两组呼出二氧化碳水平相似。术后，两组达到Aldrete评分为10分的时间相似。右美托咪定组患者的视觉模拟疼痛评分显著低于丙泊酚组。两组外科医生对患者镇静的满意度相似。右美托咪定组患者的满意度更高。
与丙泊酚镇静水平相似时，右美托咪定具有相当的血流动力学效应，能维持足够的呼吸功能，从麻醉后恢复室出院时间相似，镇痛效果更好，外科医生满意度相似，患者满意度更高。因此，右美托咪定可能是球后麻醉下行玻璃体视网膜手术患者镇静的一种有价值的辅助药物。
