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Combined use of dexmedetomidine and propofol in monitored anesthesia care: a randomized controlled study.
BMC Anesthesiol 2017; 17(1):34BA

Abstract

BACKGROUD

Although propofol and dexmedetomidine have been widely used for monitored anesthesia care, their adverse effects necessitate the search for better methods. Therefore, we performed this randomized controlled trial to evaluate the combined use of propofol and dexmedetomidine.

METHODS

Eighty-seven adult patients undergoing hand surgery under brachial plexus block were randomly allocated to receive 1.6 μg/ml of the target effect site concentration of propofol (P group) and infusion of 0.4 μg/kg/h dexmedetomidine following a loading dose of 1.0 μg/kg for 10 min (D group). The M group received a half-dose of both drugs simultaneously. The maintenance dose was adjusted to maintain an Observer Assessment of Alertness/Sedation score of 3. Cardiorespiratory variables, adverse effects, and drug efficacy were observed.

RESULTS

The significantly higher mean arterial pressure (mmHg) in the D group [P group 86.9 (12.6), D group 96.0 (12.2), M group 85.6 (10.6), p = 0.004)] and a significantly higher heart rate (beat/min) in the P group were observed [P group 67.3 (9.0), D group 57.8 (6.9), M group 59.2 (7.4), p < 0.001)]. The M group had a significant lower incidence of airway obstruction (p < 0.001) and the D group had a higher incidence of bradycardia requiring atropine (p = 0.001). The P group had higher incidences of hypoxia (p = 0.001), spontaneous movement (p < 0.001) and agitation (p = 0.001). The satisfaction scores of the patients (p = 0.007) and surgeon (p < 0.001) were higher in the M group. Onset time was significantly longer in the D group (p < 0.001).

CONCLUSIONS

The combined use of propofol and dexmedetomidine provided cardiovascular stability with decreased adverse effects. Additionally, it led to a similar onset time of propofol and achieved higher satisfaction scores.

TRIAL REGISTRATION

KCT0001284 . Retrospectively registered 25 November 2014.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, 222, Wangsimni-ro, Seongdonggu, Seoul, 133-792, Republic of Korea.Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, 222, Wangsimni-ro, Seongdonggu, Seoul, 133-792, Republic of Korea. makeitcool@hanyang.ac.kr.Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, 222, Wangsimni-ro, Seongdonggu, Seoul, 133-792, Republic of Korea.Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, 222, Wangsimni-ro, Seongdonggu, Seoul, 133-792, Republic of Korea.

Pub Type(s)

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

Language

eng

PubMed ID

28253863

Citation

Kim, Kyu Nam, et al. "Combined Use of Dexmedetomidine and Propofol in Monitored Anesthesia Care: a Randomized Controlled Study." BMC Anesthesiology, vol. 17, no. 1, 2017, p. 34.
Kim KN, Lee HJ, Kim SY, et al. Combined use of dexmedetomidine and propofol in monitored anesthesia care: a randomized controlled study. BMC Anesthesiol. 2017;17(1):34.
Kim, K. N., Lee, H. J., Kim, S. Y., & Kim, J. Y. (2017). Combined use of dexmedetomidine and propofol in monitored anesthesia care: a randomized controlled study. BMC Anesthesiology, 17(1), p. 34. doi:10.1186/s12871-017-0311-9.
Kim KN, et al. Combined Use of Dexmedetomidine and Propofol in Monitored Anesthesia Care: a Randomized Controlled Study. BMC Anesthesiol. 2017 03 1;17(1):34. PubMed PMID: 28253863.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined use of dexmedetomidine and propofol in monitored anesthesia care: a randomized controlled study. AU - Kim,Kyu Nam, AU - Lee,Hee Jong, AU - Kim,Soo Yeon, AU - Kim,Ji Yoon, Y1 - 2017/03/01/ PY - 2016/10/05/received PY - 2017/01/23/accepted PY - 2017/3/4/entrez PY - 2017/3/4/pubmed PY - 2017/11/8/medline KW - Combination drug therapy KW - Deep sedation KW - Dexmedetomidine KW - Propofol SP - 34 EP - 34 JF - BMC anesthesiology JO - BMC Anesthesiol VL - 17 IS - 1 N2 - BACKGROUD: Although propofol and dexmedetomidine have been widely used for monitored anesthesia care, their adverse effects necessitate the search for better methods. Therefore, we performed this randomized controlled trial to evaluate the combined use of propofol and dexmedetomidine. METHODS: Eighty-seven adult patients undergoing hand surgery under brachial plexus block were randomly allocated to receive 1.6 μg/ml of the target effect site concentration of propofol (P group) and infusion of 0.4 μg/kg/h dexmedetomidine following a loading dose of 1.0 μg/kg for 10 min (D group). The M group received a half-dose of both drugs simultaneously. The maintenance dose was adjusted to maintain an Observer Assessment of Alertness/Sedation score of 3. Cardiorespiratory variables, adverse effects, and drug efficacy were observed. RESULTS: The significantly higher mean arterial pressure (mmHg) in the D group [P group 86.9 (12.6), D group 96.0 (12.2), M group 85.6 (10.6), p = 0.004)] and a significantly higher heart rate (beat/min) in the P group were observed [P group 67.3 (9.0), D group 57.8 (6.9), M group 59.2 (7.4), p < 0.001)]. The M group had a significant lower incidence of airway obstruction (p < 0.001) and the D group had a higher incidence of bradycardia requiring atropine (p = 0.001). The P group had higher incidences of hypoxia (p = 0.001), spontaneous movement (p < 0.001) and agitation (p = 0.001). The satisfaction scores of the patients (p = 0.007) and surgeon (p < 0.001) were higher in the M group. Onset time was significantly longer in the D group (p < 0.001). CONCLUSIONS: The combined use of propofol and dexmedetomidine provided cardiovascular stability with decreased adverse effects. Additionally, it led to a similar onset time of propofol and achieved higher satisfaction scores. TRIAL REGISTRATION: KCT0001284 . Retrospectively registered 25 November 2014. SN - 1471-2253 UR - https://www.unboundmedicine.com/medline/citation/28253863/Combined_use_of_dexmedetomidine_and_propofol_in_monitored_anesthesia_care:_a_randomized_controlled_study_ L2 - https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-017-0311-9 DB - PRIME DP - Unbound Medicine ER -