Comparison of effects of dexmedetomidine-ketamine and dexmedetomidine-midazolam combinations in transurethral procedures.
OBJECTIVE
To compare the effects of dexmedetomidine-ketamine and dexmedetomidine-midazolam combinations on the recovery time, hemodynamic and respiratory variables, and side effects in patients undergoing transurethral procedures.


METHODS
Sixty patients scheduled for elective outpatient transurethral procedure were randomized into 2 groups. In the group K, a ketamine-dexmedetomidine combination was administered, and in the group M, midazolam-dexmedetomidine was administered, to provide sedation/analgesia. Pain and sedation levels were assessed using visual analog score (VAS) and Ramsey Sedation Scale, respectively. The recovery time was assessed with the scale of Aldrete. Time was measured and recorded to the moment at which patient responses brought the Aldrete score to 10 points. Time to eye opening and length of stay in the recovery room were recorded.


RESULTS
Group M showed significantly lower mean arterial pressure (MAP) values at 5 and 10 minutes during the procedure when compared with group K (P = .02 and P = .01, respectively). Visual analogue scale scores were greater in group M than in group K at 5 and 10 minutes for the transurethral procedure (P = .039 and P = .028, respectively). Sedation scores were similar between groups during the procedure. Time to eye opening and length of recovery room stay were shorter (P < .001 and P < .001, respectively), and Aldrete scores were greater in group K than group M.


CONCLUSIONS
Both combinations provided satisfactory sedation levels, but the dexmedetomidine-ketamine combination provided better analgesia and hemodynamic stability, with less nausea and vomiting and shorter recovery time, than the dexmedetomidine-midazolam combination.
Kirikkale University, School of Medicine, Department of Anesthesiology and Reanimation, Kirikkale, Turkey. arzuhct@hotmail.com
Emine Arzu
EA
Kose
Mehtap
M
Honca
Erdal
E
Yılmaz
Ertan
E
Batislam
Alpaslan
A
Apan
D058647:Adrenergic alpha-2 Receptor Agonists; D000328:Adult; D000700:Analgesics; D001794:Blood Pressure / Q000187:drug effects; D016292:Procedural Sedation; D020927:Dexmedetomidine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007649:Ketamine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014521:Urethra / Q000601:surgery; D013520:Urologic Surgical Procedures
D058647:Adrenergic alpha-2 Receptor Agonists; D000700:Analgesics; D004338:Drug Combinations; D020927:Dexmedetomidine; D007649:Ketamine