The comparison between propofol and dexmedetomidine infusion on perioperative  anxiety during regional anesthesia

Lim, Yong Peng; Yahya, Nurlia; Izaham, Azarinah; Kamaruzaman, Esa; Zainuddin, Muhammad Zurrusydi; Mat, Wan Rahiza Wan; Tang, Shereen Suet Ping; Zain, Jaafar Md; Mahdi, Siti Nidzwani Mohamad

doi:10.3906/sag-1802-126

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…Perhaps the difference in anxiety findings between the mentioned study and ours is due to differences in dose, method, and timing of drug administration [ 30 , 31 ]. In the study of Lim and colleagues on patients undergoing central neuroaxial blockade, the effect of the infusion of propofol and dexmedetomidine was compared; the researchers reported that dexmedetomidine caused a greater reduction in postoperative anxiety compared with propofol [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effect of melatonin, dexmedetomidine, and gabapentin on reduction of postoperative pain and anxiety following laminectomy: a randomized clinical trial

et al. 2022

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Background This study aimed to compare the effects of melatonin, dexmedetomidine, and gabapentin on postoperative pain and anxiety following laminectomy. Methods In this randomized clinical trial, 99 patients aged 40–60 years old with American Society of Anesthesiologists physical status I-II undergoing laminectomy were divided into three groups receiving 600mg gabapentin (group G), 10mg melatonin (group M), or starch tablets (group D). The Hospital Anxiety and Depression Scale (HADS) was used to measure postoperative anxiety while a Visual Analogue Scale (VAS) was employed to measure pain severity. Patients’ satisfaction with pain treatment was also measured together with the frequency of nausea and vomiting. Results The postoperative HADS decreased in all groups over time. Time and group had no significant interaction effect on the HADS score. Patients in the melatonin group had lower HADS at 2 and 6h after surgery. According to the VAS, the groups significantly differed in pain scores 6 and 24h after surgery. Lower VAS scores were observed 6h after surgery in the dexmedetomidine group compared with the gabapentin group and 24h after surgery in the dexmedetomidine group compared with the gabapentin and melatonin groups. Narcotic requirements, patients’ satisfaction, and vital sign changes did not significantly vary among the groups. Notably, patients in the melatonin group had less nausea and vomiting. Trial registration: This study was registered in the Iranian Registry of Clinical Trials (No. IRCT20141009019470N82, 29.06.2019) where the trial protocol could be accessed. Conclusion Melatonin is effective as a postoperative anti-anxiety drug. Dexmedetomidine is useful in reducing postoperative pain.

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Section: Discussionmentioning

confidence: 99%

Comparison of the effect of melatonin, dexmedetomidine, and gabapentin on reduction of postoperative pain and anxiety following laminectomy: a randomized clinical trial

et al. 2022

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“…6 A substantial body of clinical research indicates that dexmedetomidine can alleviate anxiety levels in perioperative patients. 7,8 Loh et al 9 found that dexmedetomidine can effectively reduce anxiety during magnetic resonance imaging examinations in adults. Chlan et al 10 found that dexmedetomidine effectively alleviated anxiety in intensive care unit patients.…”

Section: Editor's Perspectivementioning

confidence: 99%

Dexmedetomidine Inhibits Paraventricular Corticotropin-releasing Hormone Neurons that Attenuate Acute Stress-induced Anxiety-like Behavior in Mice

Qiu,

Wang,

Rao

et al. 2024

Anesthesiology

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Background Dexmedetomidine has repeatedly shown to improve anxiety but the precise neural mechanisms underlying this effect remain incompletely understood. Here, we aim to explore the role of corticotropin-releasing hormone-producing hypothalamic paraventricular (CRHPVN) neurons in mediating the anxiolytic effects of dexmedetomidine. Methods A social defeat stress mouse model was employed to evaluate the anxiolytic effects induced by dexmedetomidine through the elevated plus-maze, open-field test, and measurement of serum stress hormone levels. In vivo Ca2+ signal fibre photometry and ex vivo patch-clamp recordings were utilized to determine the excitability of CRHPVN neurons and investigate the specific mechanism involved. CRHPVN neuron modulation was achieved through chemogenetic activation or inhibition. Results Compared with saline, dexmedetomidine (40 µg/kg) alleviated anxiety-like behaviors. Additionally, dexmedetomidine reduced CRHPVN neuronal excitability. Chemogenetic activation of CRHPVN neurons decreased the time spent in the open arms of the elevated plus-maze and in the central area of the open-field test. Conversely, chemogenetic inhibition of CRHPVN neurons had the opposite effect. Moreover, the suppressive impact of dexmedetomidine on CRHPVN neurons was attenuated by the α2 receptor antagonist yohimbine. Conclusions Our results indicate that the anxiety-like effects of dexmedetomidine are mediated via α2 adrenergic receptor-triggered inhibition of CRHPVN neuronal excitability in the hypothalamus.

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“…Patients remain conscious during local anesthesia, which may increase perioperative anxiety 1 that exposes patients to greater surgical risk, 2 such as hemodynamic fluctuations, pain, and so forth. 3 Regional anesthesia‐assisted sedation has the advantages of reducing intraoperative bleeding, fast postoperative recovery, and so on, making it conducive to clinical application. 4 However, at present, commonly used clinical sedative drugs include propofol, midazolam, dexmedetomidine, and so on, each with limitations that restrict their utility.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of remimazolam versus propofol for intraoperative sedation during regional anesthesia: A phase II, multicenter, randomized, active‐controlled, single‐blind clinical trial

Li,

Yin,

Huang

et al. 2024

Ibrain

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This study aimed to evaluate the efficacy and safety of remimazolam for intraoperative sedation during regional anesthesia. It was a phase II‐multicenter, randomized, single‐blind, parallel‐group, active‐controlled clinical trial (No. ChiCTR2100054956). From May 6, 2021 to July 4, 2021, patients were randomly enrolled from 17 hospitals in China. A total of 105 patients aged 18–65 years who underwent selective surgery under regional anesthesia were included. Patients received different sedatives with different dosages: 0.1 mg/kg remimazolam (HR), 0.05 mg/kg remimazolam (LR), or 1.0 mg/kg propofol (P) group, followed by a maintenance infusion. Main outcome measures included the efficacy of sedation measured by Modified Observer's Assessment of Alertness/Sedation Scale (MOAA/S) levels (1–4, 1–3, 2–3, 3, and 2–4) during the sedation procedure (the duration percentage) and incidence of adverse reactions. It showed that the duration percentage of MOAA/S levels 1–4 was 100.0 [8.1]% (median [interquartile range]), 89.9 [20.2]%, 100.0 [7.7]% in the HR, LR, and P groups, respectively. The percentage of patients in the HR, LR, and P groups who achieved MOAA/S levels 1–4 within 3 min after administration was 85.7%, 58.8%, and 82.9%, respectively. However, the time to recovery from anesthesia after withdrawal of sedatives (7.9 ± 5.7 min), incidence of anterograde amnesia (75%), and adverse effects were not statistically significant among the three groups. These findings suggest that a loading dose of remimazolam 0.1 mg/kg followed by a maintenance infusion of 0–3 mg/kg/h provides adequate sedation for patients under regional anesthesia without increasing adverse reactions.

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The comparison between propofol and dexmedetomidine infusion on perioperative anxiety during regional anesthesia

Cited by 7 publications

References 11 publications

Comparison of the effect of melatonin, dexmedetomidine, and gabapentin on reduction of postoperative pain and anxiety following laminectomy: a randomized clinical trial

Comparison of the effect of melatonin, dexmedetomidine, and gabapentin on reduction of postoperative pain and anxiety following laminectomy: a randomized clinical trial

Dexmedetomidine Inhibits Paraventricular Corticotropin-releasing Hormone Neurons that Attenuate Acute Stress-induced Anxiety-like Behavior in Mice

Efficacy and safety of remimazolam versus propofol for intraoperative sedation during regional anesthesia: A phase II, multicenter, randomized, active‐controlled, single‐blind clinical trial

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