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The Effect of Intravenous Dexmedetomidine on Spinal Block and Sedation

Year 2015, Volume: 40 Issue: 1, 55 - 62, 09.09.2015
https://doi.org/10.17826/cutf.00244

Abstract

Purpose: Spinal anesthesia is often preferred anesthesia technique in urological surgery. Some patients may require sedation during spinal anesthesia. In our study, we aimed to investigate the effect of intravenous dexmedetomidine on sedation, motor and sensory blockade under spinal anesthesia with levobupivacaine. Material and Methods: Our randomised, double-blind study was applied to ASA I-III, 18-75 years old 50 patients scheduled for transurethral surgery. The patients were divided into two groups and spinal anesthesia with 5% levobupivacaine 12.5 mg was administered to all patients. Intravenous dexmedetomidine was received 1 µg/kg for loading dose before 0.5 µg/kg/hour infusion to Group D (n=25). Saline infusion was given to Group S (n=25) as the same volume and infusion rate of dexmedetomidine. Systolic, diastolic and mean arterial pressure, heart rate, peripheral oxygen saturation values, pain and sedation score, the level and duration of motor and sensorial block, recovery and patient comfort score and side effects were recorded. Results: Time to reach maximum block level and duration of spinal anesthesia were longer in Group D than Group S. Sedation scores were significantly higher in Group D than Group S intraoperatively (except 1th minute) and Araştırma Makalesi / Research Article 55 Ekici ve ark. Cukurova Medical Journal postoperatively 10th and 15th minutes. The incidence of side effects, postoperative recovery and patient comfort values were similar between the groups. Conclusion: We found that dexmedetomidine prolongs duration of motor block, provides safe and effective sedation without increasing the incidence of side effect in the patients under spinal anesthesia.

References

  • .Brown DL. Spinal, epidural and caudal anesthesia. In: Miller RD, editor. Anesthesia. Philadelphia: Churchill-Livingstone; 2000;1492–8.
  • Belleville JP, Ward DS, Bloor BC, Maze M. Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate. Anesthesiology. 1992;77:1125–33.
  • Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg. 2000;90:699–705. Intrathecal Dexmedetomidine on Low-Dose Bupivacaine Spinal Anesthesia in Elderly Patients Undergoing Transurethral Prostatectomy. Biol. Pharm. Bull. 2013;36:959– 65.
  • McVey JD, Tobias JD. Dexmedetomidine and ketamine for sedation during spinal anesthesia in children. Journal of Clinical Anesthesia. 2010;22:538–45.
  • Hong JY, Kim WO, Yoon Y, Choi Y, Kim SH, Kil HK. Effects of intravenous dexmedetomidine on low-dose bupivacaine spinal anaesthesia in elderly patients. Acta Anaesthesiol Scand. 2012;56:382–7.
  • Elcicek K, Tekin M, Kati I. The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia. J Anesth. 2010;24:544–8
  • Kanazi GE, Aouad MT, Jabbour-Khoury SI. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anesthesiol Second. 2006;50: 222-7.
  • Kaya FN, Yavaşçaoğlu B, Turker G, Yıldırım A, Gurbet A, Moğol EB, Özcan B. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Can J Anaesth. 2010;57:39-45.
  • Rhee K, Kang K, Kim J, Jeon Y. Intravenous clonidine prolongs bupivacaine spinal anesthesia.
  • Acta Anaesthesiol Scand. 2003;47:1001–5.
  • Song J, Kim WM, Lee SH, Yoon MH. Dexmedetomidine for sedation of patients undergoing elective surgery under regional anesthesia. Korean J Anesthesiol. 2013;65:203-8.

İntravenöz Deksmedetomidinin Spinal Blok ve Sedasyon Üzerine Etkisi

Year 2015, Volume: 40 Issue: 1, 55 - 62, 09.09.2015
https://doi.org/10.17826/cutf.00244

Abstract

Amaç: Spinal anestezi ürolojik girişimlerde sık tercih edilen bir anestezi yöntemidir. Bazı hastalar spinal anestezi sırasında sedasyona ihtiyaç duyabilir. Çalışmamızda, levobupivakain ile yapılan spinal anestezi altında uygulanan intravenöz deksmedetomidinin motor ve duyusal blok ve sedasyon üzerine etkilerini araştırmayı amaçladık. Materyal ve Metod: Randomize ve çift kör çalışmamız ASA I-III, 18-75 yaş arası, transüretral cerrahi planlanan 50 hasta üzerinde yapıldı. Hastalar iki gruba ayrıldı ve tüm hastalara 12.5 mg % 0.5 levobupivakain ile spinal anestezi uygulandı. Grup D (n=25)’ye 1 µg/kg yükleme dozunu takiben 0.5 µg/kg/saat deksmedetomidin infüzyonu, Grup S(n=25)’ye ise aynı volüm ve hızda salin infüzyonu uygulandı. Hastaların sistolik, diyastolik ve ortalama arter basıncı, kalp hızı, periferik oksijen satürasyon değerleri, ağrı ve sedasyon skorları, motor ve duyusal blok süreleri, derlenme ve hasta konfor skorları ve yan etkiler kaydedildi. Bulgular: Maksimum blok düzeyine ulaşma süresi ve spinal anestezi süresi Grup D’de Grup S’e göre istatistiksel olarak anlamlı daha uzun bulundu. Ramsey Sedasyon Skoru değerleri intraoperatif 1. dakika haricinde ve postoperatif 10. ve 15. dakikalarda Grup D’de Grup S’e göre istatistiksel olarak anlamlı yüksek bulundu. Yan etki sıklığı, derlenme ve hasta konforu değerleri gruplar arasında benzer bulundu. Sonuç: Spinal anestezi altında transüretral girişim yapılan hastalarda deksmedetomidin infüzyonunun motor blok süresini uzattığı, yan etki sıklığını arttırmadan etkin ve güvenli bir sedasyon sağladığı sonucuna varıldı.

References

  • .Brown DL. Spinal, epidural and caudal anesthesia. In: Miller RD, editor. Anesthesia. Philadelphia: Churchill-Livingstone; 2000;1492–8.
  • Belleville JP, Ward DS, Bloor BC, Maze M. Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate. Anesthesiology. 1992;77:1125–33.
  • Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg. 2000;90:699–705. Intrathecal Dexmedetomidine on Low-Dose Bupivacaine Spinal Anesthesia in Elderly Patients Undergoing Transurethral Prostatectomy. Biol. Pharm. Bull. 2013;36:959– 65.
  • McVey JD, Tobias JD. Dexmedetomidine and ketamine for sedation during spinal anesthesia in children. Journal of Clinical Anesthesia. 2010;22:538–45.
  • Hong JY, Kim WO, Yoon Y, Choi Y, Kim SH, Kil HK. Effects of intravenous dexmedetomidine on low-dose bupivacaine spinal anaesthesia in elderly patients. Acta Anaesthesiol Scand. 2012;56:382–7.
  • Elcicek K, Tekin M, Kati I. The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia. J Anesth. 2010;24:544–8
  • Kanazi GE, Aouad MT, Jabbour-Khoury SI. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anesthesiol Second. 2006;50: 222-7.
  • Kaya FN, Yavaşçaoğlu B, Turker G, Yıldırım A, Gurbet A, Moğol EB, Özcan B. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Can J Anaesth. 2010;57:39-45.
  • Rhee K, Kang K, Kim J, Jeon Y. Intravenous clonidine prolongs bupivacaine spinal anesthesia.
  • Acta Anaesthesiol Scand. 2003;47:1001–5.
  • Song J, Kim WM, Lee SH, Yoon MH. Dexmedetomidine for sedation of patients undergoing elective surgery under regional anesthesia. Korean J Anesthesiol. 2013;65:203-8.
There are 11 citations in total.

Details

Primary Language English
Journal Section Research
Authors

Abdurrahman Ekici This is me

Mediha Türktan

Tayfun Güler This is me

Publication Date September 9, 2015
Published in Issue Year 2015 Volume: 40 Issue: 1

Cite

MLA Ekici, Abdurrahman et al. “The Effect of Intravenous Dexmedetomidine on Spinal Block and Sedation”. Cukurova Medical Journal, vol. 40, no. 1, 2015, pp. 55-62, doi:10.17826/cutf.00244.