Comparison of an Intraoperative Infusion of Dexmedetomidine or Remifentanil on Perioperative Haemodynamics, Hypnosis and Sedation, and Postoperative Pain Control

Abstract

This prospective, randomized, doubleblind study compared the effects of dexmedetomidine and remifentanil on haemodynamic stability, sedation and postoperative pain control in the postanaesthetic care unit (PACU). Fifty consecutive patients scheduled for total laparoscopic hysterectomy were randomly assigned to receive infusions of either dexmedetomidine (1 µg/kg) i.v. over 10 min followed by 0.2 -0.7 µg/kg per h continuous i.v. infusion or remifentanil (0.8 -1.2 µg/kg) i.v. over 1 min followed by 0.05 -0.1 µg/kg i.v. per min, starting at the end of surgery to the time in the PACU. Modified observer's assessment of alertness scores were significantly lower in the dexmedetomidine group than in the remifentanil group at 0, 5 and 10 min after arrival in the PACU. Blood pressure and heart rate in the dexmedetomidine group were significantly lower than that recorded in the remifentanil group in the PACU. Dexmedetomidine, at the doses used in this study, had a significant advantage over remifentanil in terms of postoperative haemodynamic stability.

Efficacy of dexmedetomidine on postoperative shivering: a meta-analysis of clinical trials

“…Nevertheless, this meta-analysis has several limitations. First, only eight trials 3,[21][22][23]35,37,44,47 reported the source of their funding; and therefore, we did not know Fig. 6 Results of subgroup analysis of the incidence of postoperative shivering by routes of dexmedetomidine administration whether the other trials were supported by industry, which could make the design prone to show the drug in its best light.…”

A comparative study of the efficacy of intravenous Paracetamol and Dexmedetomidine on peri-operative hemodynamics and post-operative analgesia for patients undergoing laparoscopic cholecystectomy

“…Jung et al . in their comparative study showed significant advantage of Dexmedetomidine at dose of 1 μ g/kg bolus followed by 0.2-0.7 μ g/kg/h infusion for 24 h.[10] It is a safe sedative alternative to benzodiazepine/opioid combination in patients undergoing monitored anesthesia care for a multitude of procedures because of its analgesic, “co-operative sedation” and lack of respiratory depression properties. [11] Several findings lead to the conclusion that the major sedative and antinociceptive effects of Dexmedetomidine are attributable to its stimulation of the α-2 adrenoceptors in the locus coeruleus.…”

“…in a prospective randomized double blind study compared the effects of Dexmedetomidine and remifentanil on hemodynamic stability, sedation and post-operative pain control in PACU with the Dexmedetomidine at a dose of 1 μ g/kg IV over 10 min followed by 0.2-0.7 μ g/kg/h continuous IV infusion had a significant advantage in terms of post-operative hemodynamic stability. [10]…”

Effect of dexmedetomidine, midazolam, and propofol on lipopolysaccharide‑stimulated dendritic cells

“…Recently, the effects of these sedative drugs on inflammation have been considered (1,2), and for both clinical and in vitro studies have compared the effects of these three drugs on inflammation models (3,4). Propofol and midazolam has shown anti-inflammatory properties in a variety of experimental models (1,5), while dexmedetomidine, a highly selective agonist of α2-adrenergic receptors, may have a biphasic effect on cells (6).…”