Efficacy of dexmedetomidine on peritoneal dialysis catheter insertion

Nakayama, Takashin; Uchiyama, Kiyotaka; Morimoto, Kohkichi; Washida, Naoki; Kasai, Takahiro; Nakamichi, Ran; Kusahana, Ei; Wakino, Shu; Itoh, Hiroshi

doi:10.1007/s11255-021-02916-5

Cited by 2 publications

(2 citation statements)

References 32 publications

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“…However, it cannot completely eliminate the pain associated with intraoperative peritoneal stretching [ 2 ]. General anesthesia yields a good analgesic effect; however, it is associated with high risk in patients with ESRD [ 3 ]. Regional blockade anesthesia, such as transverse abdominal block, has fewer side effects during PD catheter implantation [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Conscious sedation anesthesia using different doses of remifentanil combined with dexmedetomidine for peritoneal dialysis catheter implantation

Yang,

Liu,

Ren

et al. 2023

Renal Failure

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Background Conscious sedation anesthesia (CSA) is an anesthetic method during peritoneal dialysis catheter implantation. However, lack of optimal CSA strategies for patients with end-stage renal disease (ESRD). This study aimed to evaluate the analgesic effects and safety of CSA using different doses of remifentanil combined with dexmedetomidine during peritoneal dialysis catheter insertion. Methods Patients who underwent peritoneal dialysis (PD) catheter placement via open surgical incision were retrospectively analyzed and divided into three groups based on the tertile dose of remifentanil. The bispectral index (BIS) was used to monitor the depth of anesthesia. Data regarding clinical findings, the effects of anesthesia, and the incidence of drug-related adverse effects were collected. Results In total, 102 patients completed the surgery successfully and safely. The dose of remifentanil was 0.02–0.07 μg/kg/min, 0.08–0.13 μg/kg/min, and 0.14–0.20 μg/kg/min in Groups A, B, and C, respectively. Only seven patients reported mild pain during the surgery. No significant differences were observed among the numeric rating scale scores of the three groups ( p > 0.05). Intraoperative hemodynamics were stable. The incidence of respiratory depression was 8.3%, 20.0%, and 41.9% in Groups A, B, and C, respectively ( p < 0.01). The incidence of gastrointestinal symptoms in Group C (51.6%) was higher than that in Groups A and B ( p < 0.05). Conclusion Low-dose remifentanil (0.02–0.07 μg/kg/min) combined with dexmedetomidine achieved satisfactory anesthetic effects with fewer adverse drug reactions during PD catheter implantation, indicating its potential for use in patients undergoing PD catheter placement.

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Section: Introductionmentioning

confidence: 99%

Conscious sedation anesthesia using different doses of remifentanil combined with dexmedetomidine for peritoneal dialysis catheter implantation

Yang,

Liu,

Ren

et al. 2023

Renal Failure

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“…Dexmedetomidine, a highly selective a 2 adrenergic agonist with sedative, analgesic, and antioxidant effects, has been used for PD catheter insertion to safely improve operative analgesia and provide potential renal-protective effects [6][7][8]. Recently, dexmedetomidine has been safely and effectively used with regional blockades to potentiate the analgesic properties of ropivacaine, reduce sufentanil consumption, and provide protective effects without any major side effects [9].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the effect of perineural dexmedetomidine on oxidative stress during peritoneal dialysis catheter insertion: a randomized, controlled trial

et al. 2022

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Purpose This study aimed to evaluate the effect of the addition of dexmedetomidine to ropivacaine on oxidative stress during transversus abdominis plane (TAP) and rectus sheath (RS) blockades for patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD) catheter insertion. Methods Sixty patients with ESRD undergoing PD catheter insertion to receive left ultrasound-guided TAP and RS blockades were randomly divided into two groups: the dexmedetomidine plus ropivacaine group (25 mL of 0.3% ropivacaine + 1 μg/kg dexmedetomidine) and the ropivacaine group (25 mL of 0.3% ropivacaine). Primary outcomes were oxidative stress marker levels during the procedure. Results A total of 60 patients (30 patients in each group) were evaluated. Compared with the ropivacaine group, the dexmedetomidine plus ropivacaine group had significantly lower serum malondialdehyde levels (P < 0.05) and increased glutathione peroxidase (P < 0.01) and superoxide dismutase levels at 24 h after the procedure (P < 0.01). Conclusion The addition of 1 μg/kg of dexmedetomidine to ropivacaine for ultrasound-guided TAP and RS blockades could inhibit oxidative stress in patients with ESRD undergoing PD catheter insertion. Trial registration This study was registered at www.chictr.org.cn on June 7, 2021 (ChiCTR2100047050).

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Efficacy of dexmedetomidine on peritoneal dialysis catheter insertion

Cited by 2 publications

References 32 publications

Conscious sedation anesthesia using different doses of remifentanil combined with dexmedetomidine for peritoneal dialysis catheter implantation

Conscious sedation anesthesia using different doses of remifentanil combined with dexmedetomidine for peritoneal dialysis catheter implantation

Assessment of the effect of perineural dexmedetomidine on oxidative stress during peritoneal dialysis catheter insertion: a randomized, controlled trial

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