The comparison of monitored anesthesia care with dexmedetomidine and spinal anesthesia during varicose vein surgery

Abstract

PurposeThe purpose of this study was to investigate the effectiveness and safety of monitored anesthesia care (MAC) using dexmedetomidine for its sedative and analgesic effect during varicose vein surgery.MethodsForty-two patients, who underwent varicose vein surgery, were divided into the MAC group (n = 20) or the spinal anesthesia group (n = 22) for randomized clinical trial. In the MAC group, dexmedetomidine was administered by a loading dose of 1 µg/kg for 10 minutes, followed by a maintenance infusion of 0.2-1.0 µg/kg/hr. Ketamine was used for intermittent injection. In the spinal anesthesia group, midazolam was used for sedation. Intraoperative vital signs, the number of adverse events, and the satisfaction of patients and surgeons concerning the anesthetic condition were compared between the two groups.ResultsSystolic blood pressure was intraoperatively significantly different over time between the two groups. The groups had statistical differences in the change in heart rate with regard to time. In the postanesthetic care unit, patients and surgeons in the MAC group had a lower satisfaction score, compared to patients and surgeons in the spinal anesthesia group. However, in the recovery period, patients had a positive perception concerning MAC anesthesia. In addition, without significant adverse events, the MAC group had a shorter time to possible ambulation, which indicated an early recovery.ConclusionWe believe that MAC using dexmedetomidine in combination with ketamine may be an alternative anesthetic technique for varicose vein surgery with regard to a patient's preference and medical condition.

Monitored anesthesia care for great saphenous vein stripping surgery with target controlled infusion of propofol and remifentanil: a prospective study

“…Great or small saphenous vein stripping is a commonly performed surgical procedure as a treatment for varicose veins of the lower extremity. There are several anesthetic methods, including general anesthesia, neuraxial block, and peripheral nerve blocks, such as femoral nerve block, popliteal nerve block, and posterior cutaneous nerve block [ 1 2 3 4 ]. Monitored anesthesia care (MAC) with local anesthesia is another option for patients undergoing vein stripping.…”

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“…Eun-Jin Moon et al 14 compared monitored anaestesia care (MAC) with dexmedetomidine (1 µg/kg) and intermittent ketamine with spinal anaesthesia(SA) for patient satisfaction using ISAS scale{Iowa satisfaction with anaesthesia scale. The verbal rating scale 0(worst) to 10(best)} and concluded that patient's(p=0.018) and surgeon's satisfaction(p=0.001) were lower in MAC group (7.4 and 6.2 respectively) compared to SA group (9.0 and 9.1 respectively).…”