title: [Effect of low dose dexmedetomidine premedication on propofol consumption in geriatric end stage renal disease patients].
abstract: OBJECTIVE
  Sedation in dialysis dependent end-stage renal disease patients requires caution as a result of performing high doses of sedatives and its complications. Multidrug sedation regimens might be superior and advantage on lesser drug consumption and by the way adverse events which occur easily in end-stage renal disease patients. We evaluated the effects of dexmedetomidine premedication on propofol consumption, sedation levels with Observer's Assessment of Alertness and Sedation scores and the bispectral index and the hemodynamic changes, potential side effects in geriatric patients with end-stage renal disease who underwent hip fracture surgery under spinal anesthesia.
  
  
  METHODS
  In this randomized, controlled, double-blind study 60 elderly patients (age≥65 years) with end-stage renal disease and hip fracture scheduled for anterograde femoral intramedullary nailing were assigned to groups that received either intravenous saline infusion (Group C) or dexmedetomidine 0.5μg/kg/10min infusion for premedication (Group D). All the patients received propofol infusion after the induction of the spinal anesthesia.
  
  
  RESULTS
  Total propofol consumption, propofol dose required for targeted sedation levels according to Observer's Assessment of Alertness and Sedation scores and bispectral index levels, recovery times were significantly lower in Group D (p<0.001). The time to reach to Observer's Assessment of Alertness and Sedation score 4 and to achieve bispectral index≤80 was significantly lower in Group C compared with Group D (p<0.001). Adverse events were similar in both groups.
  
  
  CONCLUSIONS
  Dexmedetomidine premedication lowers intraoperative propofol consumption to maintain targeted level of sedation. Therefore low dose dexmedetomidine premedication in addition to propofol infusion might be an alternative in geriatric patients with end-stage renal disease for sedation.
authors: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Baskent, Adana, Turquia. Electronic address: pergenoglu@yahoo.com.
authors: Pinar
authors: P
authors: Ergenoglu
authors: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Baskent, Adana, Turquia.
authors: Sule
authors: S
authors: Akin
authors: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Baskent, Adana, Turquia.
authors: Cagla
authors: C
authors: Bali
authors: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Baskent, Adana, Turquia.
authors: Hatice Evren
authors: HE
authors: Eker
authors: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Baskent, Adana, Turquia.
authors: Oya
authors: O
authors: Yalcin Cok
authors: Departamento de Anestesiologia e Reanimação, Faculdade de Medicina, Universidade Baskent, Adana, Turquia.
authors: Anis
authors: A
authors: Aribogan
keywords: Dexmedetomidina; Dexmedetomidine; Doença renal em estágio terminal; End stage renal disease; Geriatric patient; Paciente geriátrico; Propofol