Intramuscular Dexmedetomidine as Premedication for General Anesthesia

Scheinin, Harry; Jaakola, Marja-Leena; Sjövall, S.; Ali‐Melkkilä, T.; Kaukinen, S.; Turunen, J.; Kanto, J.

doi:10.1097/00000542-199306000-00008

Cited by 112 publications

(52 citation statements)

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“…Also, inter group comparison shows that the studied haemodynamic parameters were consistently higher in the midazolam group than the dexmedetomidine group till the end of the study period (p < 0.05). These results are similar to Erkola et al [15], Scheinin et al [19] where they reported blood pressure and heart rate in midazolam group to be higher than the dexmedetomidine. However they used higher doses of dexmedetomidine and was associated with bradycardia and hypotension in contrast to none in our study.…”

Section: /6supporting

confidence: 90%

To Compare the Hemodynamic Changes with Single Dose of Intravenous Dexmedetomidine versus Midazolam: A Randomized, Prospective Study

Nath

Singh

Garg

et al. 2015

JACCOA

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Section: /6supporting

confidence: 90%

To Compare the Hemodynamic Changes with Single Dose of Intravenous Dexmedetomidine versus Midazolam: A Randomized, Prospective Study

Nath

Singh

Garg

et al. 2015

JACCOA

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“…Our patients were all young and fit and could be expected to have a higher resting vagal tone than older sicker patients. Significant bradycardias, including sinus pauses of 3 s [22], related to dexmedetomidine have been reported in up to 40% of patients in other studies [8,9,22]. Sinus arrest has occurred in a young healthy volunteer 3.5 h after receiving dexmedetomidine [23].…”

Section: Discussionmentioning

confidence: 86%

“…The ED 50 for the final infusion rate of propofol to abolish consciousness (loss of response to verbal command) was 3.45 mg.kg 21 (10) 116 (14) 67 (13) Before surgery 70 (10) 124 (10) 76 (11) During surgery 62 (9) 106 (14) 59 (11) Recovery ward 62 (10) 116 (12) 66 (10) No…”

Section: Resultsmentioning

confidence: 99%

The effect of intravenous dexmedetomidine premedication on the dose requirement of propofol to induce loss of consciousness in patients receiving alfentanil

Peden

Cloote

Stratford³

et al. 2001

Anaesthesia

120

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SummaryDexmedetomidine reduces the dose requirements for opioids and anaesthetic agents. We conducted a single-centre, open-label, noncomparative phase II study of the effect of intravenous dexmedetomidine on the dose requirement of propofol to induce loss of consciousness in 49 ASA I and II patients. The initial dexmedetomidine infusion scheme was reduced twice because of adverse events. Forty patients who received the final infusion scheme were randomly allocated to receive one of five stepped propofol infusions; loss of consciousness was assessed after 21 min. The ED 50 for the final infusion rate of propofol to suppress consciousness was 3.45 mg.kg 21 .h 21 (95% CL 2.7±4.2): ED 95 was 6.68 mg.kg 21 .h 21 (95% CL 5.1±19.1), EC 50 was 1.69 m g.ml 21 (95% CL 0.95±2.5) and EC 95 was 5.7 m g.ml 21 (95% CL 3.2 to . 10). Our final dose of dexmedetomidine of 0.63 m g.kg 21 caused a reduction in the overall concentration and dose of propofol required to produce loss of consciousness, but no significant shift in the dose±response curve compared with other studies. Drugs acting as agonists at a 2 -adrenoceptors may enhance anaesthesia by producing dose-related sedation, anxiolysis, decreased upper airway secretions, peri-operative haemodynamic stability and analgesia [1±3]. There is substantial evidence that the a 2 -agonists also exert an anaestheticsparing effect mediated in part through a decrease in central noradrenergic activity, but mainly through a direct effect on central a 2 -adrenoceptors in the locus coeruleus and other sites [4,5]. The a 2 -agonists also have activity at the imidazoline receptors involved in central blood pressure control [2,6,7].Dexmedetomidine, a specific, selective and potent a 2 -adrenoceptor agonist has been shown to have significant anaesthetic, sedative and analgesic-sparing effects in clinical studies [8±12]. Recently, the dose-dependent effects of dexmedetomidine on isoflurane [11] and sevoflurane [12] requirements have been assessed in humans. However, to date, no studies have explored the shift of a dose±response curve for intravenous agents in conjunction with the a 2 -agonists. We aimed to perform a descriptive dose-finding study to determine the effect of an infusion of dexmedetomidine on the dose and blood concentration of propofol required to suppress consciousness and motor activity during total intravenous anaesthesia with propofol and alfentanil.

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“…Its disadvantage is that at present it can only be given as an intramuscular or intravenous injection. Dexmedetomidine administered at an intramuscular dose of 2.5 mg.kg À1 as a premedication produced sedation and anxiolysis comparable with a midazolam dose of 80 mg.kg À1 [122]. Both clonidine [123] and dexmedetomidine [124] have been shown to have anxiolytic effects independent of sedation.…”

Section: Sedation and Anxiolysismentioning

confidence: 98%

Alpha‐2 and imidazoline receptor agonistsTheir pharmacology and therapeutic role

Khan¹,

Ferguson²,

Jones³

1999

Anaesthesia

605

423

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SummaryClonidine has proved to be a clinically useful adjunct in clinical anaesthetic practice as well as in chronic pain therapy because it has both anaesthetic and analgesic-sparing activity. The more selective alpha-2 adrenoceptor agonists, dexmedetomidine and mivazerol, may also have a role in providing haemodynamic stability in patients who are at risk of peri-operative ischaemia. The side-effects of hypotension and bradycardia have limited the routine use of alpha-2 adrenoceptor agonists. Investigations into the molecular pharmacology of alpha-2 adrenoceptors have elucidated their role in the control of wakefulness, blood pressure and antinociception. We discuss the pharmacology of alpha-2 adrenoceptors and their therapeutic role in this review.

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Intramuscular Dexmedetomidine as Premedication for General Anesthesia

Cited by 112 publications

References 0 publications

To Compare the Hemodynamic Changes with Single Dose of Intravenous Dexmedetomidine versus Midazolam: A Randomized, Prospective Study

To Compare the Hemodynamic Changes with Single Dose of Intravenous Dexmedetomidine versus Midazolam: A Randomized, Prospective Study

The effect of intravenous dexmedetomidine premedication on the dose requirement of propofol to induce loss of consciousness in patients receiving alfentanil

Alpha‐2 and imidazoline receptor agonistsTheir pharmacology and therapeutic role

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