• M Aho, O Erkola, A Kallio, H Scheinin, and K Korttila.
• Department of Anesthesia, Women's Hospital, Helsinki University Central Hospital, Finland.
• J Clin Anesth. 1993 May 1;5(3):194-203.

Study ObjectiveTo evaluate the effects of dexmedetomidine, an alpha-2 agonist, as an intravenous sedative drug and the effects of atipamezole, an alpha-2 antagonist, on recovery.DesignRandomized, double-blind study with three parallel groups. An open dose-finding study preceded it to optimize the atipamezole dose.SettingOutpatient operating room at the gynecologic and obstetric university hospital in Helsinki, Finland.PatientsSeventy-two healthy women scheduled for legal termination of pregnancy.InterventionsPatients were assigned to one of three groups of 24 patients each to receive either dexmedetomidine 2 micrograms/kg and atipamezole 50 micrograms/kg; dexmetomidine 2 micrograms/kg and saline; or midazolam 0.15 mg/kg and saline. In addition to paracervical block, each patient received two different study drugs: study drug 1 was a sedative agent (either dexmedetomidine or midazolam), administered before the procedure. If the sedation was not deep enough and the patient reacted to the procedure, a low dose of propofol was administered. Study drug 2 was a reversing agent or a placebo, administered following the procedure.Measurements And Main ResultsThe mean time to regain consciousness was shorter in the dexmedetomidine-atipamezole and the dexmedetomidine-saline groups compared with the midazolam group. Postoperative sedation, tested both by subjective and objective assessments, decreased more quickly in the dexmedetomidine-atipamezole group compared with the dexmedetomidine-saline and the midazolam groups.ConclusionAtipamezole is an effective antagonist for reversing psychomotor impairment following dexmedetomidine sedation.

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