Comparison of buccal and intramuscular dexmedetomidine premedication for arthroscopic knee surgery.
OBJECTIVE
To compare the sedative, anxiolytic, analgesic, hemodynamic, and respiratory effects of buccal dexmedetomidine with intramuscular (IM) dexmedetomidine for premedication in patients undergoing arthroscopic knee surgery during spinal anesthesia.


METHODS
Randomized, placebo-controlled trial.


METHODS
University medical center.


METHODS
75 ASA physical status I and II patients undergoing arthroscopic knee surgery with spinal anesthesia.


METHODS
Patients were randomized to one of three groups for premedication: group B, buccal dexmedetomidine 2.5 microg kg(-1); group IM, IM dexmedetomidine 2.5 microg kg(-1); and group P, buccal 0.9% and NaCl 2 mL.


METHODS
Noninvasive blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation were recorded. Sedation and anxiety levels were consecutively assessed with Ramsay sedation scores and Visual Analog Scale (VAS) scores of anxiety before premedication, before spinal anesthesia, during surgery, and at the end of surgery. Two, 4, and 8 hours after surgery, sedation levels, postoperative VAS pain scores, and consumption of analgesics (diclofenac sodium) were recorded.


RESULTS
Before spinal anesthesia, during surgery, and at the end of surgery, sedation and anxiety scores of the patients receiving buccal or IM dexmedetomidine were, respectively, higher and lower than in group P. Patients receiving buccal dexmedetomidine (group B) had lower requirement of diclofenac sodium than group P and lower pain scores than groups P and IM. Mild hypotension and bradycardia were observed in the buccal and IM dexmedetomidine patients.


CONCLUSIONS
Buccal dexmedetomidine for premedication in arthroscopic knee surgery provided equal levels of sedation and anxiolysis, and more evident analgesia compared with IM dexmedetomidine.
Karaaslan
Dilek
D
Department of Anesthesiology, Suleyman Demirel University School of Medicine, Isparta 32260, Turkey. dilek@med.sdu.edu.tr
Peker
Tulay Tuncer
TT
Alaca
Adnan
A
Ozmen
Sadik
S
Kirdemir
Pakize
P
Yorgancigil
Huseyin
H
Baydar
Metin Lutfi
ML
D000278:Administration, Buccal; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D000775:Anesthesia, Spinal / Q000379:methods; D001007:Anxiety / Q000188:drug therapy; D001182:Arthroscopy / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D016292:Procedural Sedation / Q000379:methods; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007273:Injections, Intramuscular; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement / Q000379:methods; D011292:Premedication / Q000379:methods*; D012119:Respiration / Q000187:drug effects; D013997:Time Factors
D018712:Analgesics, Non-Narcotic; D020927:Dexmedetomidine; D010100:Oxygen