The effect of low-dose dexmedetomidine on hemodynamics and anesthetic requirement during bis-spectral index-guided total intravenous anesthesia.
The purpose of this study was to evaluate the effects of low-dose dexmedetomidine on hemodynamics and anesthetic requirements during propofol and remifentanil anesthesia for laparoscopic cholecystectomy. Thirty adult patients were randomly allocated to receive dexmedetomidine infusion of 0.3 μg/kg/h (dexmedetomidine group, n = 15) or comparable volumes of saline infusion (control group, n = 15). Target controlled infusion of propofol and remifentanil was used for anesthetic induction and maintenance, and adjusted in order to maintain a bispectral index of 40-55 and hemodynamic stability. We measured hemodynamics and recorded total and mean infused dosages of propofol and remifentanil. For anesthesia induction and maintenance, mean infused doses of propofol (121 ± 27 vs. 144 ± 29 μg/kg/min, P = 0.04) and remifentanil (118 ± 27 vs. 150 ± 36 ng/kg/min, P = 0.01) were lower in the dexmedetomidine group than in the control group, respectively. The dexmedetomidine group required 16 % less propofol and 23 % less remifentanil. During anesthetic induction and maintenance, the dexmedetomidine group required fewer total doses of propofol (9.6 ± 2.3 vs. 12.4 ± 3.3 mg/kg, P = 0.01) and remifentanil (9.6 ± 3.4 vs. 12.7 ± 2.6 μg/kg, P = 0.01). The change in mean arterial pressure over time differed between the groups (P < 0.05). Significantly lower mean arterial pressure was observed in the dexmedetomidine group than in the control group at immediately and 5 min after pneumoperitoneum. The time to extubation after completion of drug administration did not differ between the groups (P = 0.25). This study demonstrated that a low-dose dexmedetomidine infusion of 0.3 μg/kg/h reduced propofol and remifentanil requirements as well as hemodynamic change by pneumoperitoneum without delayed recovery during propofol-remifentanil anesthesia for laparoscopic cholecystectomy.
['Park|Hee Yeon|HY|', 'Kim|Jong Yeop|JY|', 'Cho|Sang Hyun|SH|', 'Lee|Dongchul|D|', 'Kwak|Hyun Jeong|HJ|']
D000328:Adult D000768:Anesthesia, General D000771:Anesthesia, Intravenous D000777:Anesthetics D018686:Anesthetics, Intravenous D062186:Arterial Pressure D001794:Blood Pressure D002245:Carbon Dioxide D002763:Cholecystectomy D020927:Dexmedetomidine D005260:Female D006339:Heart Rate D006439:Hemodynamics D006801:Humans D008297:Male D008875:Middle Aged D010880:Piperidines D011027:Pneumoperitoneum D015742:Propofol D000077208:Remifentanil D013997:Time Factors
Dexmedetomidine Hemodynamics Anesthetic requirement Propofol Remifentanil