Peri-operative use of dexmedetomidine in airway reconstruction surgery for obstructive sleep apnoea.
OBJECTIVE
To evaluate the peri-operative usefulness of dexmedetomidine in obstructive sleep apnoea surgery.


METHODS
In a clinical audit, patients were divided into a study group (dexmedetomidine used; n = 125; 82.9 per cent males, 17.1 per cent females; mean age 48.1 years) and a control group (dexmedetomidine not used; n = 143; 85.5 per cent males, 14.5 per cent females; mean age 47.4 years). The selected outcome measures were mean arterial pressure, use of anti-hypertensives and use of opioids.


RESULTS
Mean arterial pressure was stable (i.e. below 100 mmHg) in 93.3 per cent of the study group and 72.0 per cent of the control group (relative risk 1.30, 95 per cent confidence interval 1.14-1.47). The use of glyceryl trinitrate and hydralazine was significantly less in the study group, compared with controls (p = 0.005 and <0.001, respectively). Study group patients underwent more procedures than control patients (p < 0.001) and were more likely to require morphine. No difference was noted in the median dose of opioids.


CONCLUSIONS
Dexmedetomidine improves haemodynamic stability in patients undergoing surgery for obstructive sleep apnoea. It is reliable and reduces the need for polypharmacy. Its opioid-sparing action has been established in the literature; however, this was not demonstrated in our study.
Department of ENT, Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia. sharadch@yahoo.com
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Chawla
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Robinson
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Norton
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Esterman
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Taneerananon
D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D001794:Blood Pressure; D016022:Case-Control Studies; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D019990:Perioperative Care; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000601:surgery*
D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine