• J Clin Anesth · May 1994

    Randomized Controlled Trial Clinical Trial

    Dexmedetomidine premedication before intravenous regional anesthesia in minor outpatient hand surgery.

    • M L Jaakola.
    • Department of Anesthesiology, Turku University Hospital, Finland.
    • J Clin Anesth. 1994 May 1;6(3):204-11.

    Study ObjectiveTo assess the efficacy and safety of intravenous (i.v.) dexmedetomidine, an alpha-2 agonist, as a premedication before i.v. regional anesthesia.DesignRandomized, double-blind, placebo-controlled study with two parallel groups.SettingDay-case surgery unit, Department of Surgery, Turku University Hospital, Turku, Finland.Patients30 healthy ASA physical status I outpatients scheduled for minor hand surgery with i.v. regional anesthesia.InterventionsPatients were assigned to one of two groups to receive either dexmedetomidine 1 microgram/kg i.v. (n = 15) or saline placebo i.v. (n = 15) 10 minutes before exsanguination and inflation of a tourniquet. Regional blockade was induced with 0.5% lidocaine 3 mg/kg (maximum 200 mg). Additional fentanyl 1 microgram/kg intraoperatively and oxycodone 0.05 mg/kg postoperatively were administered for analgesia if needed.Measurements And Main ResultsDexmedetomidine preoperatively induced 16% to 20% decreases in systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001), and heart rate (p < 0.001), which were mainly abolished within the 4-hour postoperative follow-up period. A clinically significant decrease in arterial oxygen saturation was not observed. The subjective intensity of pain during tourniquet inflation was similar in both groups, but fewer intraoperative (p = 0.009) opioid analgesics were needed in the dexmedetomidine group. Dexmedetomidine decreased sympathoadrenal responses: plasma norepinephrine concentration decreased to one-fourth of the baseline level (p < 0.001), and one of its main metabolites, 3,4-dihydroxyphenylglycol, decreased by 27% (p < 0.001). Dexmedetomidine also prevented an increase in plasma epinephrine concentration following tourniquet inflation (p = 0.003). Dexmedetomidine induced subjective sedation (p = 0.002), but the Maddox Wing test did not show any statistically significant differences between the groups. General effectiveness was graded superior in the dexmedetomidine group (p < 0.001).ConclusionsDexmedetomidine is an effective premedication before i.v. regional anesthesia because it reduces patient anxiety, sympathoadrenal responses, and opioid analgesic requirements.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.