Dexmedetomidine as intramuscular premedication for day-case cataract surgery. A comparative study of dexmedetomidine, midazolam and placebo.
The effects of dexmedetomidine 1.0 microgram.kg-1, midazolam 20 micrograms.kg-1 and saline placebo were assessed in a double-blind, randomised study in 90 patients undergoing day-case cataract surgery under regional anaesthesia. The trial drug was injected into the deltoid muscle 45 min before the peri-ocular block. Dexmedetomidine 1.0 microgram.kg-1 decreased intra-ocular pressure before, during and after surgery. The maximum reduction in mean (SD) intra-ocular pressure occurred in the dexmedetomine group just before discharge from hospital (17.7 (2.8) mmHg to 11.5 (2.9) mmHg) (p < 0.001 compared with midazolam and placebo). In contrast, midazolam did not differ from saline placebo. Dexmedetomidine and midazolam produced a similar sedative effect of short duration. Dexmedetomidine induced a moderate decrease in blood pressure (p < 0.001 compared with placebo) and a slight but statistically significant decrease in heart rate throughout the study period (p < 0.001 compared with placebo). Dexmedetomidine 1.0 microgram.kg-1 intramuscularly, effectively reduced intra-ocular pressure and produced short-acting sedation with marginal cardiovascular effects; it may be a useful premedicant drug for elderly patients undergoing day-case cataract surgery under regional anaesthesia.
Virkkilä
M
M
Department of Anaesthesiology, University of Turku, Finland.
Ali-Melkkilä
T
T
Kanto
J
J
Turunen
J
J
Scheinin
H
H
D000316:Adrenergic alpha-Agonists / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D001794:Blood Pressure / Q000187:drug effects; D002387:Cataract Extraction; D016292:Procedural Sedation; D003864:Depression, Chemical; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000494:pharmacology*; D007093:Imidazoles / Q000008:administration & dosage / Q000494:pharmacology*; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D020926:Medetomidine; D008874:Midazolam / Q000494:pharmacology; D008875:Middle Aged; D011292:Premedication / Q000379:methods*
D000316:Adrenergic alpha-Agonists; D006993:Hypnotics and Sedatives; D007093:Imidazoles; D020926:Medetomidine; D008874:Midazolam