title: Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients?
abstract: BACKGROUND
  Perioperative hemodynamic fluctuations are seen more often in hypertensive patients than in normotensive patients. The purpose of our study was to investigate the perioperative hemodynamic effects of dexmedetomidine and midazolam used for premedication in hypertensive patients relative to each other and in comparison to normotensive patients.
  
  
  METHODS
  One-hundred-forty female, normotensive or hypertensive patients undergoing myomectomies or hysterectomies. They were randomly enrolled into the subgroups: Group ND (normotensive-dexmedetomidine); Group HD (hypertensive-dexmedetomine); Group NM (normotensive-midazolam); Group HM (hypertensive- midazolam). Dexmedetomidine was administered at a concentration of 0.5 μg.kg(-1), and midazolam was administered at a concentration of 0.025 μg.kg(-1) via intravenous (IV) infusion before the induction of anaesthesia. Haemodynamic parameters were recorded at several times (T(beginning), T(preop5 min), T(preop 10 min), T(induction), T(intubation), T(intubation 5 min), T(initial surgery), T(surgery 15 min), T(surgery 30 min), T(extubation), T(extubation 5 min)). Propofol amount for induction, time between induction and initial surgery, demand of antihypertensive therapy, rescue atropine were recorded. Quantitative clinical and demographic characteristics were compared using One Way ANOVA. The values were compared using One-way Analysis of Variance. Additionally periodic variations were examined by One way Repeated Measures Analysis of Variance for groups separately.
  
  
  RESULTS
  SBP was significantly different between normotensive and hypertensive groups at the following time points: T(preop 5 min), T(preop 10 min), T(induction), T(intubation), T(intubation 5 min) and T(initial surgery). MBP was significantly different in the hypertensive groups at T(induction), T(intubation), T(intubation 5 min), T(initial surgery), T(surgery 15 min), T(surgery 30 min), T(extubation) and T(extubation 5 min). The perioperative requirements for antihypertensive drugs were significantly higher in Group HM.
  
  
  CONCLUSIONS
  In the hypertensive patients, dexmedetomidine premedication provides better hemodynamic stability compared with midazolam, and because it decreases the antihypertensive requirements, its use might be beneficial.
  
  
  BACKGROUND
  
  
  
  BACKGROUND
  Clinicaltrials.gov identifier: NCT02058485.
authors.affiliation: Department of Anesthesiology and Reanimation, Duzce University Faculty of Medicine, Duzce, Turkey.
authors.forename: Gulbin
authors.initials: G
authors.lastname: Sezen
authors.affiliation: Department of Anesthesiology and Reanimation, Duzce University Faculty of Medicine, Duzce, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Demiraran
authors.affiliation: Department of Anesthesiology and Reanimation, Duzce University Faculty of Medicine, Duzce, Turkey.
authors.forename: Ilknur Suidiye
authors.initials: IS
authors.lastname: Seker
authors.affiliation: Department of Anesthesiology and Reanimation, Duzce University Faculty of Medicine, Duzce, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Karagoz
authors.affiliation: Department of Anesthesiology and Reanimation, Duzce University Faculty of Medicine, Duzce, Turkey.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Iskender
authors.affiliation: Department of Biostatistics, Duzce University Faculty of Medicine, Duzce, Turkey.
authors.forename: Handan
authors.initials: H
authors.lastname: Ankarali
authors.affiliation: Department of Anesthesiology and Reanimation, Duzce University Faculty of Medicine, Duzce, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ersoy
authors.affiliation: Department of Anesthesiology and Reanimation, Duzce University Faculty of Medicine, Duzce, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Ozlu
mesh_terms: D000328:Adult; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications*; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000494:pharmacology*; D007044:Hysterectomy / Q000379:methods; D007262:Infusions, Intravenous; D008874:Midazolam / Q000008:administration & dosage / Q000494:pharmacology; D008875:Middle Aged; D011292:Premedication / Q000379:methods*; D013997:Time Factors; D063186:Uterine Myomectomy / Q000379:methods
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008874:Midazolam
keywords: Dexmedetomidine; Hypertension; Midazolam; Premedication