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Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation.
J Clin Anesth. 2009 May; 21(3):194-9.JC

Abstract

STUDY OBJECTIVE

To evaluate the effect of dexmedetomidine combined with fentanyl on hemodynamics.

DESIGN

Prospective, double-blinded, randomized study.

SETTING

Operating room of a university hospital.

PATIENTS

30 ASA physical status II and III patients with mild-to-moderate cardiovascular disease.

INTERVENTIONS

Patients were assigned to one of three groups: Group D-F2 [dexmedetomidine, effect-site concentration (ESC) of fentanyl = two ng/mL]; Group F2 (placebo, ESC of fentanyl = two ng/mL), or Group F4 (placebo, ESC of fentanyl = 4 ng/mL).

MEASUREMENTS

Dexmedetomidine (an initial dose of 1.0 microg/kg for 10 min, followed by a continuous infusion of 0.7 microg x kg(-1) x hr(-1)) or placebo saline was administered 15 minutes before anesthetic induction. Anesthesia was induced with propofol and fentanyl using a target-controlled infusion system. Hemodynamic parameters: systolic (SBP) and diastolic blood pressures (DBP), and heart rate (HR) during anesthetic induction were measured and the percent changes were calculated for both induction and intubation.

MAIN RESULTS

After inducing anesthesia, SBP was significantly higher in Group D-F2 (127 +/- 24 mmHg) than Group F2 (90 +/- 20 mmHg) or Group F4 (77 +/- 21 mmHg). The SBP in Groups F2 and F4 reached 160 +/- 31 mmHg and 123 +/- 36 mmHg, respectively, after intubation, but no significant change in SBP was noted in Group D-F2. The percent increase in SBP due to tracheal intubation in Group D-F2 was 3% +/- 4% and was significantly lower than that of Group F2 (70% +/- 34%) or Group F4 (45% +/- 36%).

CONCLUSION

Dexmedetomidine combined with fentanyl during anesthetic induction suppresses the decrease in blood pressure due to anesthetic induction and also blunts the cardiovascular response to tracheal intubation.

Authors+Show Affiliations

Department of Anesthesiology, Asahikawa Medical College, Asahikawa, Hokkaido, Japan. taka.kunisawa@nifty.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19464613

Citation

Kunisawa, Takayuki, et al. "Dexmedetomidine Suppresses the Decrease in Blood Pressure During Anesthetic Induction and Blunts the Cardiovascular Response to Tracheal Intubation." Journal of Clinical Anesthesia, vol. 21, no. 3, 2009, pp. 194-9.
Kunisawa T, Nagata O, Nagashima M, et al. Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation. J Clin Anesth. 2009;21(3):194-9.
Kunisawa, T., Nagata, O., Nagashima, M., Mitamura, S., Ueno, M., Suzuki, A., Takahata, O., & Iwasaki, H. (2009). Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation. Journal of Clinical Anesthesia, 21(3), 194-9. https://doi.org/10.1016/j.jclinane.2008.08.015
Kunisawa T, et al. Dexmedetomidine Suppresses the Decrease in Blood Pressure During Anesthetic Induction and Blunts the Cardiovascular Response to Tracheal Intubation. J Clin Anesth. 2009;21(3):194-9. PubMed PMID: 19464613.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation. AU - Kunisawa,Takayuki, AU - Nagata,Osamu, AU - Nagashima,Michio, AU - Mitamura,Sayuri, AU - Ueno,Megumi, AU - Suzuki,Akihiro, AU - Takahata,Osamu, AU - Iwasaki,Hiroshi, PY - 2007/10/06/received PY - 2008/07/30/revised PY - 2008/08/02/accepted PY - 2009/5/26/entrez PY - 2009/5/26/pubmed PY - 2009/8/11/medline SP - 194 EP - 9 JF - Journal of clinical anesthesia JO - J Clin Anesth VL - 21 IS - 3 N2 - STUDY OBJECTIVE: To evaluate the effect of dexmedetomidine combined with fentanyl on hemodynamics. DESIGN: Prospective, double-blinded, randomized study. SETTING: Operating room of a university hospital. PATIENTS: 30 ASA physical status II and III patients with mild-to-moderate cardiovascular disease. INTERVENTIONS: Patients were assigned to one of three groups: Group D-F2 [dexmedetomidine, effect-site concentration (ESC) of fentanyl = two ng/mL]; Group F2 (placebo, ESC of fentanyl = two ng/mL), or Group F4 (placebo, ESC of fentanyl = 4 ng/mL). MEASUREMENTS: Dexmedetomidine (an initial dose of 1.0 microg/kg for 10 min, followed by a continuous infusion of 0.7 microg x kg(-1) x hr(-1)) or placebo saline was administered 15 minutes before anesthetic induction. Anesthesia was induced with propofol and fentanyl using a target-controlled infusion system. Hemodynamic parameters: systolic (SBP) and diastolic blood pressures (DBP), and heart rate (HR) during anesthetic induction were measured and the percent changes were calculated for both induction and intubation. MAIN RESULTS: After inducing anesthesia, SBP was significantly higher in Group D-F2 (127 +/- 24 mmHg) than Group F2 (90 +/- 20 mmHg) or Group F4 (77 +/- 21 mmHg). The SBP in Groups F2 and F4 reached 160 +/- 31 mmHg and 123 +/- 36 mmHg, respectively, after intubation, but no significant change in SBP was noted in Group D-F2. The percent increase in SBP due to tracheal intubation in Group D-F2 was 3% +/- 4% and was significantly lower than that of Group F2 (70% +/- 34%) or Group F4 (45% +/- 36%). CONCLUSION: Dexmedetomidine combined with fentanyl during anesthetic induction suppresses the decrease in blood pressure due to anesthetic induction and also blunts the cardiovascular response to tracheal intubation. SN - 1873-4529 UR - https://www.unboundmedicine.com/medline/citation/19464613/Dexmedetomidine_suppresses_the_decrease_in_blood_pressure_during_anesthetic_induction_and_blunts_the_cardiovascular_response_to_tracheal_intubation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0952-8180(09)00076-2 DB - PRIME DP - Unbound Medicine ER -