Editorial I

Shelly, M. P.

doi:10.1093/bja/87.5.677

Cited by 31 publications

(6 citation statements)

References 13 publications

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“…In order to enhance recovery and discharge, postoperative physical and psychological stress therapy should be given attention [ 38 ]. Studies have indicated that dexmedetomidine provides excellent effect of sedation without respiratory depression [ 5 , 39 - 41 ]. In our study, dexmedetomidine beneficially affected the postoperative emotional state (assessed on the QoR-15 dimension of emotion), which was consistent with previously published studies.…”

Section: Discussionmentioning

confidence: 99%

Effect of dexmedetomidine infusion for intravenous patient-controlled analgesia on the quality of recovery after laparotomy surgery

et al. 2017

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BackgroundThe Quality of Recovery-15 (QoR-15) is a patient-centered questionnaire to evaluate the recovery after surgery and anesthesia. Dexmedetomidine has sedative, analgesic, antiinflammatory and inhibitory sympathetic effects, which may contribute to early recovery. We hypothesized dexmedetomidine added to intravenous patient-controlled analgesia (PCA) could enhance the quality of recovery (QoR) in patients undergoing laparotomy surgery.MethodsIn this randomized, double-blind, controlled study, 100 patients undergoing laparotomy surgery were randomly allocated into two groups: Dexmedetomidine (group D) and control (group S). Patients in the group D (n = 46) received dexmedetomidine 0.04 ug/(kg·h) plus sufentanil 0.02 ug/(kg·h) for 48 h after laparotomy surgery, and in the group S (n = 47) received sufentanil 0.04 ug/(kg·h) only. The QoR-15 scores, postoperative pain, rescue analgesia, recovery of gastrointestinal function, patient satisfaction and adverse effects were recorded.ResultsThe QoR-15 scores were significantly higher in the group D than in the group S on postoperative day (POD) 1, 2, 3 and 5 (P < 0.05). The visual analog scale (VAS) scores were significantly lower in the group D compared with group S within 48 h after surgery (P < 0.05). The pressing times of analgesic pump and rescue tramadol were not significantly different between the two groups (P > 0.05). The incidence of nausea was significantly lower in the Group D. No hypotension, bradycardia, or respiratory depression was observed.ConclusionsThe addition of dexmedetomidine to PCA enhanced patient-centered recovery, reduced pain and adverse effect, and improved patient satisfaction after laparotomy surgery.

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Section: Discussionmentioning

confidence: 99%

Effect of dexmedetomidine infusion for intravenous patient-controlled analgesia on the quality of recovery after laparotomy surgery

et al. 2017

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“…Although the advantage of dexmedetomidine was hemodynamic stability, there are contradictory results related to its hemodynamic effects in the literature. [7–91618–20] In our study, an initial dose of propofol was administered for 10 minutes both to allow for equivalent modes of dexmedetomidine and propofol administration and to minimize cardiovascular and respiratory depression related to the initial dose. Hypotension and bradycardia have been reported, particularly with large bolus dosing regimens, in patients with pre existing cardiac problems and in patients administered an initial dose in 10 minutes.…”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine is a potent, highly selective α2 adrenoreceptor agonist having a distribution half-life of approximately 8 min and a terminal half-life of 3.5 h.[67] At therapeutic doses, dexmedetomidine provides profound levels of sedation without affecting cardiovascular and respiratory stability. [7–9] There is a significant interest in the use of propofol for sedation in children in the MRI setting, because of its predictability, rapid onset, and offset of action.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging

Dave

Vaghela

2011

Saudi Journal of Anaesthesia

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Aim:To compare the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging procedures.Methods:Sixty children between the age of 1 to 7 years were randomly distributed into two groups: The dexmedetomidine (D) group received 1 μg/kg initial dose followed by continuous infusion of 0.5 μg/kg/h, and the propofol group (P) received 3 mg/kg initial dose, followed by a continuous infusion of 100 μg/kg/min. Inadequate sedation was defined as difficulty in completing the procedure because of the child's movement during magnetic resonance imaging. Mean arterial pressure (MAP), heart rate, peripheral oxygen saturation, and respiratory rate (RR) were recorded during the study.Result:The onset of sedation, recovery, and discharge time were significantly shorter in group P than in group D. MAP, heart rate, and RR decreased during sedation from the baseline values in both groups. MAP and RR were significantly lower in group P than in group D during sedation. Dexmedetomidine and propofol provided adequate sedation in most of the children.Conclusion:We conclude that although propofol provided faster anesthetic induction and recovery times, it caused hypotension and desaturation. Dexmedetomidine could be an alternative, reliable sedative drug to propofol in selected patients.

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“… 10 This eventually leads to a decreased release of norepinephrine from the presynaptic neuron and attenuates central nervous excitation, especially in the locus coeruleus. 10 , 12 – 14 Dexmedetomidine has been reported to have an eight times higher affinity for the α-2 receptor than clonidine. 11 , 15 …”

Section: Review Of Mechanism Of Action and Pharmacokineticsmentioning

confidence: 99%

Sedation with dexmedetomidine in the intensive care setting

Gerlach¹,

Murphy²

2011

OAEM

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Dexmedetomidine is an α-2 agonist that produces sedation and analgesia without compromising the respiratory drive. Use of dexmedetomidine as a sedative in the critically ill is associated with fewer opioid requirements compared with propofol and a similar time at goal sedation compared with benzodiazepines. Dexmedetomidine may produce negative hemodynamic effects including lower mean heart rates and potentially more bradycardia than other sedatives used in the critically ill. Recent studies have demonstrated that dexmedetomidine is safe at higher dosages, but more studies are needed to determine whether the efficacy of dexmedetomidine is dose dependent. In addition, further research is required to define dexmedetomidine’s role in the care of delirious critically ill patients, as many, but not all, studies have indicated favorable outcomes.

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Editorial I

Cited by 31 publications

References 13 publications

Effect of dexmedetomidine infusion for intravenous patient-controlled analgesia on the quality of recovery after laparotomy surgery

Effect of dexmedetomidine infusion for intravenous patient-controlled analgesia on the quality of recovery after laparotomy surgery

A comparison of the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging

Sedation with dexmedetomidine in the intensive care setting

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