Low-Dose Dexmedetomidine Reduces Median Effective Concentration (EC 50) of Propofol More than Fentanyl in Unparalysed Anaesthetised Patients for I-gel Insertion: a Randomised Controlled Trial

Ganesh, Venkata; Luthra, Ankur; Amburu, Vamsidhar; Naik, B Naveen; Singh, Ajay; Puri, Govardhan Dutt

doi:10.1016/j.accpm.2021.100815

Cited by 2 publications

(5 citation statements)

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“…Although there is a substantial body of evidence on dexmedetomidine use in pediatric patients, studies on its opioid-equivalent efficacy and recovery characteristics are scarce. Low-dose dexmedetomidine has been studied as an opioid substitute in adults [ 15 25 ]; however, to our knowledge, this is the first RCT evaluating the opioid substitution property and recovery characteristics of low-dose dexmedetomidine against fentanyl in a pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…An ideal opioid-free anesthetic agent should be rapid in onset and offset, with smooth emergence, minimal cardiovascular effects, and a predictable response. As a highly selective α-2 adrenergic agonist, dexmedetomidine possesses several of these desirable properties, which are beneficial in the ambulatory setting [ 13 14 15 ]. Dexmedetomidine exhibits anxiolytic, analgesic, sympatholytic, and opioid-sparing effects at low doses (< 0.5 µg/kg) [ 15 16 17 18 19 20 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…As a highly selective α-2 adrenergic agonist, dexmedetomidine possesses several of these desirable properties, which are beneficial in the ambulatory setting [ 13 14 15 ]. Dexmedetomidine exhibits anxiolytic, analgesic, sympatholytic, and opioid-sparing effects at low doses (< 0.5 µg/kg) [ 15 16 17 18 19 20 21 ]. Many pediatric studies have also reported other benefits of low-dose dexmedetomidine [ 16 17 18 19 20 21 ], such as decreased incidence of emergence agitation [ 19 22 23 ], emergence delirium [ 19 24 ], postoperative pain [ 23 19 ], and reduced sevoflurane consumption [ 19 ] with a better hemodynamic profile [ 18 19 20 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, evidence related to the recovery characteristics of low-dose dexmedetomidine is scarce. To our knowledge, no study has evaluated the opioid-equivalent efficacy of low-dose dexmedetomidine in pediatric patients for GA, although this has been reported in adults [ 15 25 ].…”

Section: Introductionmentioning

confidence: 99%

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Improved postoperative recovery profile in pediatric oral rehabilitation with low-dose dexmedetomidine as an opioid substitute for general anesthesia: a randomized double-blind clinical trial

Naik

Jaiswal

Ganesh

et al. 2022

J Dent Anesth Pain Med

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Background Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 µg/kg for 4 min for induction, followed by maintenance of 0.4 µg/kg/h. Group F received an infusion of fentanyl 1 µg/kg over 4 min for induction, followed by maintenance at 1 µg/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation–Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44–6.2) vs. 6.25 (4.21–7) minutes in groups D vs. F (P = 0.001), respectively, while the corresponding awakening times were 19 (18.75–21) and 22.5 (22–24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Improved postoperative recovery profile in pediatric oral rehabilitation with low-dose dexmedetomidine as an opioid substitute for general anesthesia: a randomized double-blind clinical trial

Naik

Jaiswal

Ganesh

et al. 2022

J Dent Anesth Pain Med

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“…Detection of blood oxygen metabolism indicators [20] Partial pressure of oxygen (PaO 2 ), partial pressure of carbon dioxide (PaCO 2 ) and pH were detected and compared.…”

Section: Measurement Of Laboratory Indicators [19]mentioning

confidence: 99%

Effect of transversus abdominis plane block combined with low-dose dexmedetomidine on elderly patients undergoing laparoscopic colectomy.

Zhang¹,

Hao²

2023

Videosurgery and Other Miniinvasive Techniques

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Introduction Colon cancer is a common malignancy, for which surgery is currently the preferred therapy. Aim To assess the effect of transversus abdominis plane block (TAPB) combined with low-dose dexmedetomidine on elderly patients undergoing laparoscopic colectomy. Material and methods Sixty-two elderly patients undergoing laparoscopic colectomy between March 2021 and March 2022 were randomly selected and equally divided into Group A (low-dose dexmedetomidine) and Group B (TAPB + low-dose dexmedetomidine) by the randomized double-blind method. The treatment outcomes were compared. Results The resting and active Visual Analogue Scale and Pittsburgh Sleep Quality Index scores were lower in Group B than those in Group A at 6 h, 1 day, 2 days and 3 days after operation (p < 0.05). The two groups had no significant differences in the levels of cluster of differentiation 4+ (CD4+), CD8+ and free Cor, CD4+/CD8+ ratio and NK cell level before anesthesia (p > 0.05). At 24 h after the operation, the level of CD4+, CD4+/CD8+ ratio and NK cell level were higher in Group B than those in Group A, and the levels of CD8+ and free Cor were lower in Group B (p < 0.05). Group B had higher partial pressure of oxygen ((45.52 ±11.14) mm Hg) and pH (7.42 ±0.06) (p < 0.05) and lower partial pressure of carbon dioxide ((4.05 ±0.32) mm Hg) than those of Group A (p < 0.05). Conclusions TAPB combined with low-dose dexmedetomidine can exert better anesthetic, analgesic and sedative effects, and ameliorate stress responses.

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Low-Dose Dexmedetomidine Reduces Median Effective Concentration (EC 50) of Propofol More than Fentanyl in Unparalysed Anaesthetised Patients for I-gel Insertion: a Randomised Controlled Trial

Cited by 2 publications

References 15 publications

Improved postoperative recovery profile in pediatric oral rehabilitation with low-dose dexmedetomidine as an opioid substitute for general anesthesia: a randomized double-blind clinical trial

Improved postoperative recovery profile in pediatric oral rehabilitation with low-dose dexmedetomidine as an opioid substitute for general anesthesia: a randomized double-blind clinical trial

Effect of transversus abdominis plane block combined with low-dose dexmedetomidine on elderly patients undergoing laparoscopic colectomy.

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