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Dexmedetomidine-based versus fentanyl-based total intravenous anesthesia for lumbar laminectomy.
Minerva Anestesiol. 2008 Sep; 74(9):469-74.MA

Abstract

BACKGROUND

The present study was designed to show the effects of dexmedetomidine infusion with loading dosage on perioperative hemodynamics, propofol consumption, and postoperative recovery when used for general anesthesia in patients undergoing spinal laminectomy.

METHODS

Fifty American Society of Anesthesiologists (ASA) I-II patients were randomised into two groups. Group D received dexmedetomidine 0.6 microg kg(-1) as bolus before induction and 0.2 microg kg(-1) h(-1) by infusion. Group F received fentanyl 1 microg kg(-1) as bolus before induction and 0.5 microg kg(-1) h(-1) by infusion. Signs of inadequate analgesia, defined as an increase in heart rate and mean arterial pressure (MAP) 20% above the baseline, were managed by increasing or decreasing the dosage of dexmedetomidine and fentanyl. Statistical analysis was performed with student t, chi-squared and Fisher's exact tests.

RESULTS

The maintenance dosage was 0.64+/-0.06 microg kg(-1) h(-1) for fentanyl in Group F and 0.31+/-0.08 microg kg(-1) h(-1) for dexmedetomidine in Group D. MAP values in Group D were significantly higher than in Group F only after intubation. Before and after extubation, MAP values in Group F were significantly higher than those in Group D. There was no statistical difference in heart rate between the groups. Propofol dosages for induction (1.40+/-0.48 mgkg(-1)) and maintenance of anesthesia (2.03+/-0.41 mg kg(-1)) were lower with dexmedetomidine. Extubation time and postanesthesia care unit discharge time were similar in both groups. The fentanyl group patients required supplemental analgesia earlier than the dexmedetomidine group (34.8+/-1.35 min vs 60.4+/-1.04 min). Postoperative nausea and vomiting were significantly higher in Group F.

CONCLUSION

In conclusion, propofol-dexmedetomidine is suitable for patients undergoing elective spinal laminectomy and provides stable perioperative hemodynamic responses. Propofol-fentanyl medication requires a higher dosage of postoperative analgesics and causes frequent postoperative nausea and vomiting compared with propofol-dexmedetomidine.

Authors+Show Affiliations

Department of Anaesthesiology and Reanimation, Ministry of Health, Okmeydani Research and Training Hospital, Istanbul, Turkey. neturgut@ttnet.net.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18762754

Citation

Turgut, N, et al. "Dexmedetomidine-based Versus Fentanyl-based Total Intravenous Anesthesia for Lumbar Laminectomy." Minerva Anestesiologica, vol. 74, no. 9, 2008, pp. 469-74.
Turgut N, Turkmen A, Gökkaya S, et al. Dexmedetomidine-based versus fentanyl-based total intravenous anesthesia for lumbar laminectomy. Minerva Anestesiol. 2008;74(9):469-74.
Turgut, N., Turkmen, A., Gökkaya, S., Altan, A., & Hatiboglu, M. A. (2008). Dexmedetomidine-based versus fentanyl-based total intravenous anesthesia for lumbar laminectomy. Minerva Anestesiologica, 74(9), 469-74.
Turgut N, et al. Dexmedetomidine-based Versus Fentanyl-based Total Intravenous Anesthesia for Lumbar Laminectomy. Minerva Anestesiol. 2008;74(9):469-74. PubMed PMID: 18762754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dexmedetomidine-based versus fentanyl-based total intravenous anesthesia for lumbar laminectomy. AU - Turgut,N, AU - Turkmen,A, AU - Gökkaya,S, AU - Altan,A, AU - Hatiboglu,M A, PY - 2008/9/3/pubmed PY - 2009/1/23/medline PY - 2008/9/3/entrez SP - 469 EP - 74 JF - Minerva anestesiologica JO - Minerva Anestesiol VL - 74 IS - 9 N2 - BACKGROUND: The present study was designed to show the effects of dexmedetomidine infusion with loading dosage on perioperative hemodynamics, propofol consumption, and postoperative recovery when used for general anesthesia in patients undergoing spinal laminectomy. METHODS: Fifty American Society of Anesthesiologists (ASA) I-II patients were randomised into two groups. Group D received dexmedetomidine 0.6 microg kg(-1) as bolus before induction and 0.2 microg kg(-1) h(-1) by infusion. Group F received fentanyl 1 microg kg(-1) as bolus before induction and 0.5 microg kg(-1) h(-1) by infusion. Signs of inadequate analgesia, defined as an increase in heart rate and mean arterial pressure (MAP) 20% above the baseline, were managed by increasing or decreasing the dosage of dexmedetomidine and fentanyl. Statistical analysis was performed with student t, chi-squared and Fisher's exact tests. RESULTS: The maintenance dosage was 0.64+/-0.06 microg kg(-1) h(-1) for fentanyl in Group F and 0.31+/-0.08 microg kg(-1) h(-1) for dexmedetomidine in Group D. MAP values in Group D were significantly higher than in Group F only after intubation. Before and after extubation, MAP values in Group F were significantly higher than those in Group D. There was no statistical difference in heart rate between the groups. Propofol dosages for induction (1.40+/-0.48 mgkg(-1)) and maintenance of anesthesia (2.03+/-0.41 mg kg(-1)) were lower with dexmedetomidine. Extubation time and postanesthesia care unit discharge time were similar in both groups. The fentanyl group patients required supplemental analgesia earlier than the dexmedetomidine group (34.8+/-1.35 min vs 60.4+/-1.04 min). Postoperative nausea and vomiting were significantly higher in Group F. CONCLUSION: In conclusion, propofol-dexmedetomidine is suitable for patients undergoing elective spinal laminectomy and provides stable perioperative hemodynamic responses. Propofol-fentanyl medication requires a higher dosage of postoperative analgesics and causes frequent postoperative nausea and vomiting compared with propofol-dexmedetomidine. SN - 1827-1596 UR - https://www.unboundmedicine.com/medline/citation/18762754/Dexmedetomidine_based_versus_fentanyl_based_total_intravenous_anesthesia_for_lumbar_laminectomy_ L2 - http://www.minervamedica.it/index2.t?show=R02Y2008N09A0469 DB - PRIME DP - Unbound Medicine ER -