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Optimal dose of dexmedetomidine for sedation during epidural anesthesia
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Type
Academic journal
Author
이현수 (부산대학교 의학전문대학원 양산부산대학교병원 마취통증의학과) 백승훈 (부산대학교) 윤지욱 (부산대학교) Byeon Gyeong-Jo (부산대학교) 김희영 (양산부산대학교병원 마취통증의학과) 윤정필 (양산부산대학교병원 마취통증의학과)
Journal
대한마취통증의학회(구 대한마취과학회) Anesthesia and Pain Medicine Anesthesia and Pain Medicine Vol.12 No.3 KCI Accredited Journals
Published
2017.1
Pages
261 - 265 (5page)

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Optimal dose of dexmedetomidine for sedation during epidural anesthesia
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Background: Sedation during epidural anesthesia can reduce patients’ anxiety and discomfort. Dexmedetomidine has sedative, hypnotic, and analgesic effects, with minimal respiratory depression. However, the use of dexmedetomidine is associated with prolonged recovery. This study investigated the optimal dose of intravenous dexmedetomidine for proper sedation with minimal recovery time in epidural anesthesia. Methods: Sixty-three patients (American Society of Anesthesiologists physical status I/II) were randomized into two groups. Following epidural anesthesia, a loading dose (1 g/kg) of dexmedetomidine was administered for 10 min followed by maintenance infusion as follows: Group A (n = 32; dexmedetomidine 0.6 g/kg/h) and Group B (n = 31; dexmedetomidine 1.0 g/kg/h). Heart rate, blood pressure, and bispectral index score (BIS) were recorded during surgery. The length of stay and modified Aldrete score (MAS) were measured in the postanesthesia care unit (PACU). Results: Length of stay in the PACU was longer in Group B than in Group A (P ＜ 0.05). The MAS was higher in Group A after 30 min in the PACU (P ＜ 0.05). The BIS did not significantly differ between the two groups from baseline to 150 min after infusion of dexmedetomidine. BIS values were significantly higher in Group A at 160 min (P ＜ 0.05). The mean arterial pressure in Group B was significantly lower in the PACU. Conclusions: A dexmedetomidine loading dose of 1 g/kg/10 min followed by a maintenance dose of 0.6 g/kg/h was appropriate for surgery with a duration of 120 min or longer.

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Crowninshield RD / 2006 / Changing demographics of patients with total joint replacement / Clin Orthop Relat Res 443:266~272 google schola Guay J / 2014 / Neuraxial blockade for the prevention of postoperative mortality and major morbidity: an overview of Cochrane systematic reviews / Cochrane Database Syst Rev (1):CD010108 google schola Liu J / 2013 / Neuraxial anesthesia decreases postoperative systemic infection risk compared with general anesthesia in knee arthroplasty / Anesth Analg 117:1010~1016 google schola Pugely AJ / 2013 / Differences in short-term complications between spinal and general anesthesia for primary total knee arthroplasty / J Bone Joint Surg 95:193~199 google schola Farag E / 2005 / Epidural analgesia improves early rehabilitation after total knee replacement / J Clin Anesth 17:281~285 google schola

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