title: The effect of low-dose dexmedetomidine on hemodynamics and anesthetic requirement during bis-spectral index-guided total intravenous anesthesia.
abstract: The purpose of this study was to evaluate the effects of low-dose dexmedetomidine on hemodynamics and anesthetic requirements during propofol and remifentanil anesthesia for laparoscopic cholecystectomy. Thirty adult patients were randomly allocated to receive dexmedetomidine infusion of 0.3 μg/kg/h (dexmedetomidine group, n = 15) or comparable volumes of saline infusion (control group, n = 15). Target controlled infusion of propofol and remifentanil was used for anesthetic induction and maintenance, and adjusted in order to maintain a bispectral index of 40-55 and hemodynamic stability. We measured hemodynamics and recorded total and mean infused dosages of propofol and remifentanil. For anesthesia induction and maintenance, mean infused doses of propofol (121 ± 27 vs. 144 ± 29 μg/kg/min, P = 0.04) and remifentanil (118 ± 27 vs. 150 ± 36 ng/kg/min, P = 0.01) were lower in the dexmedetomidine group than in the control group, respectively. The dexmedetomidine group required 16 % less propofol and 23 % less remifentanil. During anesthetic induction and maintenance, the dexmedetomidine group required fewer total doses of propofol (9.6 ± 2.3 vs. 12.4 ± 3.3 mg/kg, P = 0.01) and remifentanil (9.6 ± 3.4 vs. 12.7 ± 2.6 μg/kg, P = 0.01). The change in mean arterial pressure over time differed between the groups (P < 0.05). Significantly lower mean arterial pressure was observed in the dexmedetomidine group than in the control group at immediately and 5 min after pneumoperitoneum. The time to extubation after completion of drug administration did not differ between the groups (P = 0.25). This study demonstrated that a low-dose dexmedetomidine infusion of 0.3 μg/kg/h reduced propofol and remifentanil requirements as well as hemodynamic change by pneumoperitoneum without delayed recovery during propofol-remifentanil anesthesia for laparoscopic cholecystectomy.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea.
authors.forename: Hee Yeon
authors.initials: HY
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Republic of Korea.
authors.forename: Jong Yeop
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, San 5, Wonchon-dong, Yeongtong-gu, Suwon, 443-721, Republic of Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Cho
authors.affiliation: Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea.
authors.forename: Dongchul
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Gachon University, Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea. hyun615@gilhospital.com.
authors.forename: Hyun Jeong
authors.initials: HJ
authors.lastname: Kwak
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D000777:Anesthetics / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D062186:Arterial Pressure; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000737:chemistry; D002763:Cholecystectomy; D020927:Dexmedetomidine / Q000008:administration & dosage*; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage; D011027:Pneumoperitoneum; D015742:Propofol / Q000008:administration & dosage; D000077208:Remifentanil; D013997:Time Factors
chemical_list: D000777:Anesthetics; D018686:Anesthetics, Intravenous; D010880:Piperidines; D002245:Carbon Dioxide; D020927:Dexmedetomidine; D000077208:Remifentanil; D015742:Propofol
keywords: Anesthetic requirement; Dexmedetomidine; Hemodynamics; Propofol; Remifentanil