Dexmedetomidine as a substitute for remifentanil in ambulatory gynecologic laparoscopic surgery.
OBJECTIVE
To compare dexmedetomidine with remifentanil in desflurane based ambulatory gynecologic laparoscopic surgery, in respect to its effects on orientation, discharge time, nausea-vomiting, and postoperative analgesic need.


METHODS
Sixty 20-40 year old ASA I-II patients undergoing gynecologic laparoscopic surgery were randomized into 2 groups. This study was performed in the operating theaters of the Hacettepe University Faculty of Medicine, Hacettepe, Turkey in 2004 as a prospective, randomized, and double blinded study. The remifentanil group (group R), and dexmedetomidine group (group D) received a bolus of 1 microg/kg over 10 minutes, followed by 0.2 microg/kg/minute peroperative infusion of remifentanil, and 0.4 microg/kg/hour of dexmedetomidine. Hemodynamic parameters, time to extubation, and to orientation to person, place, and date, postoperative nausea, vomiting, pain, analgesic requirement at home, and satisfaction with anesthesia were recorded.


RESULTS
Demographic, hemodynamic data, postoperative pain scores, and discharge time were similar in both groups. Time to extubation, to orientation to person, to place and date were shorter in group R. Postoperative nausea, vomiting, and analgesic requirements at home were less in group D.


CONCLUSIONS
This study demonstrated that dexmedetomidine infusion causes a relatively slow recovery with reduced postoperative nausea, vomiting, and analgesic requirements, and similar hemodynamics compared to remifentanil in ambulatory laparoscopic surgeries. It may be an alternative to remifentanil in ambulatory anesthesia.
Salman
Nevriye
N
Anaesthesiology and Reanimation Department, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Uzun
Sennur
S
Coskun
Fehmi
F
Salman
Mehmet A
MA
Salman
Akgun E
AE
Aypar
Ulku
U
D000556:Ambulatory Surgical Procedures; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D010535:Laparoscopy / Q000379:methods*; D010880:Piperidines / Q000008:administration & dosage*; D011446:Prospective Studies; D000077208:Remifentanil
D006993:Hypnotics and Sedatives; D010880:Piperidines; D020927:Dexmedetomidine; D000077208:Remifentanil