Comparison of dexmedetomidine and midazolam for monitored anesthesia care combined with tramadol via patient-controlled analgesia in endoscopic nasal surgery: A prospective, randomized, double-blind, clinical study

Karaaslan, Kazım; Yılmaz, Faruk; Gülcü, Nebahat; COLAK, C; Şereflican, Murat; Koçoğlu, Hasan

doi:10.1016/s0011-393x(07)00032-x

Cited by 6 publications

(5 citation statements)

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“…In accordance with Gurbet et al [16] who stated that intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements. Also the analgesic effects of dexmedetomidine had been appreciated in various setting and various populations [17][18][19]. Our results showed that the sensory block was significantly prolonged in the dexmedetomidine group in comparison to the control group, which confirm that the intrathecal doses of dexmedetomidine used in our study prolonged the sensory block.…”

Section: Discussionsupporting

confidence: 82%

Bupivacaine-Dexmedetomidine for Lumber Discectomy: Randomized Controlled Placebo Study

Mohamed¹,

Salem²

2015

J Anesth Clin Res

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Section: Discussionsupporting

confidence: 82%

Bupivacaine-Dexmedetomidine for Lumber Discectomy: Randomized Controlled Placebo Study

Mohamed¹,

Salem²

2015

J Anesth Clin Res

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“…[ 17 ] and Karaaslan et al . [ 24 ] Midazolam sedation in our study was associated with lower patient satisfaction, higher pain scores and more use of rescue analgesic. The method of sedation was described as excellent in most of patients in Group D (77.7%) versus 7.4% of patients in Group M ( P <0.001).…”

Section: Discussionmentioning

confidence: 74%

Dexmedetomidine versus midazolam for conscious sedation in endoscopic retrograde cholangiopancreatography: An open-label randomised controlled trial

Sethi¹,

Mohammed²,

Bhatia³

et al. 2014

Indian J Anaesth

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Background:Traditionally, midazolam has been used for providing conscious sedation in endoscopic retrograde cholangiopancreatography (ERCP). Recently, dexmedetomidine has been tried, but very little evidence exists to support its use.Objective:The primary objective was to compare haemodynamic, respiratory and recovery profile of both drugs. Secondary objective was to compare the degree of comfort experienced by patients and the usefulness of the drug to endoscopist.Study Design:Open-label Randomised Controlled Trial.Methods:Subjects between 18 and 60 years of age with American Society of Anaesthesiologist Grade I-II requiring ERCP were enrolled in two groups (30 each). Both groups received fentanyl 1 μg/kg IV at the beginning of ERCP. Group M received IV midazolam (0.04 mg/kg) and additional 0.5 mg doses until Ramsay Sedation Scale (RSS) score reached 3-4. Group D received dexmedetomidine at loading dose of 1 μg/kg over 10 min followed by 0.5 μg/kg/h infusion until RSS reached 3-4. The vital parameters (heart rate (HR), blood pressure (BP), respiration rate, SpO2), time to achieve RSS 3-4 and facial pain score (FPS) were compared during and after the procedure. In the recovery room, time to reach modified Aldrete score (MAS) 9-10 and patient and surgeon's satisfaction scores was also recorded and compared. Any complication during or after the procedure were also noted.Results:In Group D, patients had lower HR and FPS at 5, 10 and 15 min following the initiation of sedation (P<0.05). There was no statistically significant difference in BP and respiratory rate. The procedure elicited a gag response in 29 (97%) and 7 (23%) subjects in Group M and Group D respectively (P<0.05). MAS of 9-10 at 5 min during recovery was achieved in 27 (90%) subjects in Group D in contrast to 5 (17%) in Group M (P<0.05). Dexmedetomidine showed higher patient and surgeon satisfaction scores (P<0.05).Conclusion:Dexmedetomidine can be a superior alternative to midazolam for conscious sedation in ERCP.

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“…This is in accordance with Gurbet et al²⁷ The analgesic effects of dexmedetomidine had been appreciated in various setting and various population. 31,32,33,34 Dexmedetomidine was associated with significant longer emergence time and time to total recovery from anaesthesia compared to esmolol.³⁵ Emergence time and time needed to achieve ≥9 of modified Aldrete score were significantly shorter in E group than DEX group, ((4.37±0.92) min. and 9.47±1.61 min.…”

Section: Discussionmentioning

confidence: 96%

Comparison of Dexmedetomidine and Esmolol for Induction of Controlled Hypotension in Spine Surgeries

Valecha¹,

Gandhi²,

Arora³

2016

jemds

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OBJECTIVEA comparative study to evaluate the efficacy of dexmedetomidine as a hypotensive agent in comparison to esmolol in Spine surgeries. METHODS60 patients ASA I or II scheduled for routine spine surgeries were equally randomly assigned to receive either dexmedetomidine or esmolol. In DEX group, patients received loading dose of 1 μg/kg dexmedetomidine diluted in 10 mL 0.9% saline infused over 10 min. before induction of anaesthesia, followed by continuous infusion of 0.5 μg/kg/h. In E group, patients received esmolol as a loading dose 1 mg/kg as 10 mL total vol. in saline infused over 1 min. followed by continuous infusion of 0.5 mg/kg/h. In both groups, aim was to maintain MAP within 55-65 mmHg. All patients were premedicated with IV glycopyrrolate 5 μg/Kg, IV midazolam 0.05 mg/kg and fentanyl 2 μg/kg. Patients received standard anaesthetic technique with propofol 2 mg/kg. Anaesthesia was maintained with O2, N2O, sevoflurane at 2 MAC and atracurium 0.1 mg/kg. Surgical field was assessed using Average Category Scale and average blood loss was calculated. Hemodynamic variables (MAP and HR); intraoperative fentanyl consumption; Emergence time and total recovery from anaesthesia (Aldrete score ≥9) were recorded. Sedation score was determined at 15, 30, 60 min. after tracheal extubation and time to first analgesic request was recorded. RESULTSBoth DEX group and E group reached the desired MAP (55-65 mmHg) with no intergroup differences in MAP or HR. The average category scale for quality of the surgical field in the range of MAP (55-65 mmHg) were <=2 with no significant differences between group scores during hypotensive period. The induction propofol dose was significantly lower in DEX group than E group (1.63±0.19 mg/kg) versus (2.00±0.05 mg/kg) respectively (P<0.000). Baseline values of MAP and HR were comparable in both groups. Mean intraoperative fentanyl consumption in DEX group was significantly less than E group (21.67±22.75 µg vs 77.17±27.85 µg). Emergence time and time to achieve ≥9 modified. Aldrete scores were significantly shorter in E group than DEX group .4.37±0.92 min. and 9.47±1.61 min. versus 8.5±1.9 min. and 4.95±1.24 min. (P<0.001). Incidence of intraoperative hypotension and bradycardia were seen in Esmolol group in 3.33 % cases. CONCLUSIONBoth dexmedetomidine and esmolol with sevoflurane are safe agents for controlled hypotension and are effective in providing ideal surgical field during spine surgeries. Compared with esmolol, dexmedetomidine offers the advantage of inherent analgesic, sedative and reduces dose of inducing agent.

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Comparison of dexmedetomidine and midazolam for monitored anesthesia care combined with tramadol via patient-controlled analgesia in endoscopic nasal surgery: A prospective, randomized, double-blind, clinical study

Cited by 6 publications

References 0 publications

Bupivacaine-Dexmedetomidine for Lumber Discectomy: Randomized Controlled Placebo Study

Bupivacaine-Dexmedetomidine for Lumber Discectomy: Randomized Controlled Placebo Study

Dexmedetomidine versus midazolam for conscious sedation in endoscopic retrograde cholangiopancreatography: An open-label randomised controlled trial

Comparison of Dexmedetomidine and Esmolol for Induction of Controlled Hypotension in Spine Surgeries

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