[Dexmedetomidine/propofol association for plastic surgery sedation during local anesthesia.].
OBJECTIVE
Dexmedetomidine is a new alpha2-adrenergic receptor agonist with potentially useful characteristics for anesthesia. This comparative study aimed at evaluating the effects of dexmedetomidine on propofol requirements and cardiovascular/respiratory stability during plastic surgery sedation under local anesthesia.


METHODS
Participated in this study 40 female patients aged 16 to 60 years, physical status ASA I or II, scheduled for elective face, nose and breast plastic surgeries under local anesthesia. Patients were randomly allocated into two groups of twenty patients: C (control) and D (dexmedetomidine). Sedation was achieved in both groups with 1 mg.kg-1 bolus propofol followed by continuous infusion at an adjusted rate to provide conscious sedation. Group D patients received continuous intravenous dexmedetomidine at a rate of 0.01 microg.kg-1.min-1, concomitant with propofol infusion. The following were evaluated: effect of dexmedetomidine on propofol requirements; cardiovascular (SBP, DBP, MBP, HR) and respiratory (SpO2, P ET CO2) parameters; quality of perioperative bleeding control and postanesthetic recovery features.


RESULTS
Mean propofol infusion rate was lower in group D (35.2 +/- 5.3 microg.kg-1.min-1) as compared to group C (72.6 +/- 8.5 microg.kg-1.min-1). Mean SBP, DBP, MBP values have decreased as from 30 min in group D, remaining stable until procedure completion, while in Group C they have increased. HR remained stable in group D where as increased as from 30 min in group C. Mean time to open eyes under command was lower in group D (6.3 +/- 2.5 min) as compared to group C (8.9 +/- 2.7 min). Perioperative bleeding control was better in group D as compared to group C.


CONCLUSIONS
Dexmedetomidine/propofol association for sedation is safe and has the following advantages: decrease in propofol requirements, cardiovascular stability, good perioperative bleeding control, lack of significant effects on ventilation.
Nociti
José Roberto
JR
CET, SBA.
Serzedo
Paulo Sérgio Mateus
PS
Zuccolotto
Eduardo Barbin
EB
Sebben
Fabiana
F
Gonzales
Raul F
RF