Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Anam Hospital, Seoul, Korea.
Korean J Anesthesiol. 2013 Aug;65(2):114-20. doi: 10.4097/kjae.2013.65.2.114. Epub 2013 Aug 27.
Dexmedetomidine is an α2-adrenoreceptor agonist with sedative, analgesic and anxiolytic effects, and it has more selective α2-adrenergic effect than clonidine. We evaluate the effect of preansethetic dexmedetomidine 1 µg/kg single infusion on sedation, hemodynamics, anesthetic consumption, and recovery profiles during anesthesia.
Forty-two female patients with American Society of Anesthesiologists physical status I or II undergoing gynecologic surgery with anticipated operation time of 2 h, were randomly assigned to receive dexmedetomidine 1 µg/kg (Dex group) or saline (control group) iv over 10 min before anesthetic induction. After tracheal intubation with propofol 2 mg/kg, cisatracurium 0.15 mg/kg iv, anesthesia was maintained with sevoflurane, O2 50%, N2O 50% around a BIS value of 40.
After study drug infusion, BIS of Dex group was lower than that of control group (93.9 ± 3.1 vs 51.5 ± 5.2, P < 0.05). Mean arterial pressure (MAP) and heart rate (HR) after intubation were increased in control group, but did not change in Dex group. During maintenance, there was no difference in MAP between groups, but HR of Dex group was lower compared to that of control group. End-tidal concentration (2.0 ± 0.5 vol% vs 1.4 ± 0.3 vol%, P < 0.05) and total cumulative consumption of sevoflurane (34.6 ± 3.8 ml vs 26.5 ± 5.3 ml, P < 0.05) were lower in Dex group than in control group. Recovery profiles, modified Aldrete score, postoperative nausea vomiting, and visual analogue pain score were not significantly different between groups.
Preanesthetic dexmetomidine 1 µg/kg single infusion is a simple, easy, and economic general anesthetic adjuvant that maintains stable hemodynamics and decrease anesthetic consumption without the change of recovery profiles.
右美托咪定是一种 α2-肾上腺素受体激动剂，具有镇静、镇痛和解焦虑作用，与可乐定相比，它具有更选择性的 α2-肾上腺素能作用。我们评估麻醉前给予 1μg/kg 右美托咪定单次输注对镇静、血流动力学、麻醉药物消耗和麻醉恢复特征的影响。
42 名美国麻醉医师协会身体状况 I 或 II 级的女性患者，接受妇科手术，预计手术时间为 2 小时，随机分为两组：右美托咪定 1μg/kg（Dex 组）或生理盐水（对照组）静脉输注 10 分钟，然后行异丙酚 2mg/kg、顺式阿曲库铵 0.15mg/kg 静脉诱导气管插管，然后以七氟醚、50%O2 和 50%N2O 维持麻醉，BIS 值在 40 左右。
研究药物输注后，Dex 组的 BIS 低于对照组（93.9±3.1 比 51.5±5.2，P<0.05）。对照组插管后平均动脉压（MAP）和心率（HR）升高，但 Dex 组无变化。维持期两组 MAP 无差异，但 Dex 组 HR 低于对照组。呼气末浓度（2.0±0.5 体积%比 1.4±0.3 体积%，P<0.05）和七氟醚总累积消耗量（34.6±3.8ml 比 26.5±5.3ml，P<0.05）也低于对照组。两组的恢复特征、改良 Aldrete 评分、术后恶心呕吐和视觉模拟疼痛评分无显著差异。
麻醉前给予 1μg/kg 右美托咪定单次输注是一种简单、易用、经济的全身麻醉辅助药物，可维持血流动力学稳定，减少麻醉药物消耗，而不改变恢复特征。
