Dexmedetomidine Reduces Intraocular Pressure, Intubation Reponses and Anaesthetic Requirements in Patients Undergoing Ophthalmic Surgery

Jaakola, Marja-Leena; Ali‐Melkkilä, T.; Kanto, J.; Kallio, Antero; Scheinin, Harry; Scheinin, Mika

doi:10.1093/bja/68.6.570

Cited by 155 publications

(124 citation statements)

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“…Jaakola et al studied the effect of dexmedetomidine infusion on intraocular pressure, hemodynamic and sympathoadrenal responses to intubation in ophthalmic surgical patients. 12 The dosage used was 0.6 mcg/kg which was lesser than the dosage we used in our study. The dosage we used in our study was 1 mcg/kg.…”

mentioning

confidence: 73%

Effect of intravenous dexmedetomidine (1 and micro;g/kg) in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preservative free 2% lignocaine (1.5mg/kg)

Saibaba

Indurkar

2016

Int J Res Med Sci

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Background: Haemodynamic variation during layngoscopy/intubation is always a matter of concern for Anesthesiologists. A stable circulatory system is the wish of all performing general anaesthesia. Hence an acceptable and easy method needs to be established to prevent the haemodynamic variations. Our aim was to evaluate the effect of intravenous Dexmedetomidine (1µg/kg) infusion in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preservative free 2% Lignocaine (1.5mg/kg). Methods: In this study, 60 patients, aged between 18-60 years belonging to ASA I and II are included. They were randomly divided into 2 groups, each comprising of 30. In group D, patients were given Dexmedetomidine 1µg/kg IV infusion over 10min and in group L, patient were given Lignocaine 1.5mg/kg IV. Results: In group D, the systolic, diastolic, mean arterial pressure and heart rate decreased significantly, from baseline, at first, second, third, fourth and fifth minute post intubation. In group L, the systolic, diastolic, mean arterial pressure and heart rate increased from baseline at first and second minute and then decreased at third, fourth and fifth minute post intubation. Conclusions: When compared between the two groups all the hemodynamic parameters showed statistical significance. There are no significant side effects and severe haemodynamic variability like hypotension and bradycardia. Therefore we concluded that Dexmedetomidine is superior to lignocaine in blunting the hemodynamic response to laryngoscopy and endotracheal intubation without any significant side effects.

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mentioning

confidence: 73%

Effect of intravenous dexmedetomidine (1 and micro;g/kg) in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preservative free 2% lignocaine (1.5mg/kg)

Saibaba

Indurkar

2016

Int J Res Med Sci

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“…Interestingly, Jaakola et al (1992) described a decrease in IOP after administration of dexmedetomidine in humans. However, they used a lower dose of dexmedetomidine (0.0006 mg/kg).…”

Section: Discussionmentioning

confidence: 99%

“…Based on these findings, it was concluded that dexmedetomidine, in combination with mydriatics, may be used in ophthalmic surgical or diagnostic procedures, which require complete dilation of the pupil. Jaakola et al (1992) studied the effects of a single intravenous dose of 0.0006 mg/kg of dexmedetomidine on IOP in humans. After dexmedetomidine administration, there was a 34% reduction in IOP.…”

mentioning

confidence: 99%

Influence of dexmedetomidine-propofol-isoflurane and medetomidine-propofol-isoflurane on intraocular pressure and pupil size in healthy dogs

Raušer¹,

Mrázová²,

Zapletalová³

2016

Vet. Med. - Czech

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ABSTRACT:The present prospective, randomised, double-blinded clinical study was designed to investigate the commonly used anaesthetic combinations of dexmedetomidine-propofol-isoflurane and medetomidine-propofolisoflurane on intraocular pressure and pupil size in dogs. Forty client-owned healthy dogs with no ocular abnormalities, average body weight of 25.7 ± 13.1 kg (mean ± SD) and aged 3.7 ± 2.7 years, were enrolled. Twenty four males and 16 females were included. Dogs were allocated randomly to receive dexmedetomidine i.v. at 0.005 mg/ kg, dexmedetomidine at 0.01 mg/kg, medetomidine at 0.01 mg/kg or medetomidine at 0.02 mg/kg. Ten minutes later anaesthesia was induced in all dogs with propofol and maintained with isoflurane in oxygen-air. Intraocular pressure, pupil size, heart rate, respiratory frequency and arterial blood pressures (SAP, DAP) were measured prior to (baseline) and at 10 (before propofol), 20, 30, 40, 50 and 60 min after dexmedetomidine or medetomidine administration. Oxygen saturation of haemoglobin (SpO 2 ) and end-tidal CO 2 concentration (EtCO 2 ) was monitored following anaesthesia induction. Data were analysed using Anderson-Darling and Bartlett's tests for data distribution and homogeneity of variance confirmation and ANOVA followed by Dunnett's tests for multiple comparisons. Changes were considered significant when P < 0.05. Following drug administration, pupil size, heart rate and respiratory frequency decreased significantly within groups, but did not differ between groups. No significant changes in intraocular pressure, SAP and DAP within and between groups, and SpO 2 or EtCO 2 between groups, were observed. Comparable doses of dexmedetomidine or medetomidine combined with propofol and isoflurane induced reductions in pupil size, respiratory frequency and heart rate, however, without a significant influence on intraocular pressure or arterial blood pressure.

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“…We identified 425 studies between 1988 and July 2007, of which 20 studies [13,14,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] fulfilled our inclusion criteria ( Fig. 1).…”

Section: Included Studiesmentioning

confidence: 99%

Dexmedetomidine and cardiac protection for non‐cardiac surgery: a meta‐analysis of randomised controlled trials

Biccard¹,

Goga²,

Beurs³

2007

Anaesthesia

122

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SummaryWe conducted a systematic review of the effects of dexmedetomidine on cardiac outcomes following non-cardiac surgery. We included prospective, randomised peri-operative studies of dexmedetomidine that reported mortality, cardiac morbidity or adverse drug events. A PubMed Central and EMBASE search was conducted up to July 2007. The reference lists of identified papers were examined for further trials. Of 425 studies identified, 20 were included in the metaanalysis (840 patients). Dexmedetomidine was associated with a trend towards improved cardiac outcomes; all-cause mortality (OR 0.27, 95% CI 0.01-7.13, p = 0.44), non-fatal myocardial infarction (OR 0.26, 95% CI 0.04-1.60, p = 0.14), and myocardial ischaemia (OR 0.65, 95% CI 0.26-1.63, p = 0.36). Peri-operative hypotension (26%, OR 3.80, 95% CI 1.91-7.54, p = 0.0001) and bradycardia (17%, OR 5.45, 95% CI 2.98-9.95, p < 0.00001) were significantly increased. An anticholinergic did not reduce the incidence of bradycardia (p = 0.43). A randomised placebocontrolled trial of dexmedetomidine is warranted. Major peri-operative cardiac events (cardiac death, nonfatal myocardial infarction and non-fatal cardiac arrest) have been reported in 1.4% of unselected patients undergoing elective non-cardiac surgery [1,2] and between 2.6 and 5.8% in selected patients considered to be at risk of cardiac disease [1]. Peri-operative cardiac events are approximately evenly distributed between myocardial oxygen supply demand imbalance and plaque rupture [3,4]. In addition, these cardiac events may be precipitated by a number of potential triggers in the perioperative period, including inflammation, surgical stress, hypercoagulable states and peri-operative hypoxic episodes [1]. It has therefore been estimated that, at best, a single medical therapy could be expected to result in a relative risk reduction of 20-35% for the composite endpoint of cardiac death, non-fatal myocardial infarction and non-fatal cardiac arrest in the peri-operative period [2].There has been considerable interest in the utility of adrenergic antagonists in decreasing peri-operative cardiac events. Beta-adrenergic antagonists decrease peri-operative myocardial ischaemia, although it is controversial whether this results in an improved cardiac outcome [5,6]. In addition, beta-adrenergic antagonists significantly increase the incidence of drug-associated hypotension and bradycardia which require treatment [6]. It is unclear whether these side-effects adversely affect the cardioprotective efficacy of peri-operative beta-blockade.Unfortunately, some patients may not realise the potential cardioprotective benefits of peri-operative beta-blockade, as this may be either contra-indicated or difficult to initiate in the peri-operative period in patients with active bronchospasm, conduction disorders or decompensated cardiac failure. Alpha-2 agonists may be an alternative anti-adrenergic therapy in these patients. Alpha-2 agonists decrease central noradrenergic activity of the locus coeruleus [7] with a decrease in...

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Dexmedetomidine Reduces Intraocular Pressure, Intubation Reponses and Anaesthetic Requirements in Patients Undergoing Ophthalmic Surgery

Cited by 155 publications

References 0 publications

Effect of intravenous dexmedetomidine (1 and micro;g/kg) in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preservative free 2% lignocaine (1.5mg/kg)

Effect of intravenous dexmedetomidine (1 and micro;g/kg) in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preservative free 2% lignocaine (1.5mg/kg)

Influence of dexmedetomidine-propofol-isoflurane and medetomidine-propofol-isoflurane on intraocular pressure and pupil size in healthy dogs

Dexmedetomidine and cardiac protection for non‐cardiac surgery: a meta‐analysis of randomised controlled trials

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