Determination of the effective dose of dexmedetomidine to achieve loss of consciousness during anesthesia induction
BackgroundDexmedetomidine (DEX) is a sedative with greater preservation of cognitive function, reduced respiratory depression, and improved patient arousability. This study was designed to investigate the performance of DEX during anesthesia induction and to establish an effective DEX induction stra...
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| Format: | Article |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1158085/full |
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| author | Bing Mu Wenjie Xu Hongyi Li Zizheng Suo Xiaoxiao Wang Yuxiang Zheng Yi Tian Bowen Zhang Jie Yu Naiyuan Tian Nan Lin Dan Zhao Zhaoxu Zheng Hui Zheng Cheng Ni |
| author_facet | Bing Mu Wenjie Xu Hongyi Li Zizheng Suo Xiaoxiao Wang Yuxiang Zheng Yi Tian Bowen Zhang Jie Yu Naiyuan Tian Nan Lin Dan Zhao Zhaoxu Zheng Hui Zheng Cheng Ni |
| author_sort | Bing Mu |
| collection | DOAJ |
| description | BackgroundDexmedetomidine (DEX) is a sedative with greater preservation of cognitive function, reduced respiratory depression, and improved patient arousability. This study was designed to investigate the performance of DEX during anesthesia induction and to establish an effective DEX induction strategy, which could be valuable for multiple clinical conditions.MethodsPatients undergoing abdominal surgery were involved in this dose-finding trial. Dixon's up-and-down sequential method was employed to determine the effective dose of DEX to achieve the state of “loss of consciousness”, and an effective induction strategy was established with continuous infusion of DEX and remifentanil. The effects of DEX on hemodynamics, respiratory state, EEG, and anesthetic depth were monitored and analyzed.ResultsThrough the strategy mentioned, the depth of surgical anesthesia was successfully achieved by DEX-led anesthesia induction. The ED50 and ED95 of the initial infusion rate of DEX were 0.115 and 0.200 μg/kg/min, respectively, and the mean induction time was 18.3 min. The ED50 and ED95 of DEX to achieve the state of “loss of consciousness” were 2.899 (95% CI: 2.703–3.115) and 5.001 (95% CI: 4.544–5.700) μg/kg, respectively. The mean PSI on the loss of consciousness was 42.8 among the patients. During anesthesia induction, the hemodynamics including BP and HR were stable, and the EEG monitor showed decreased α and β powers and increased θ and δ in the frontal and pre-frontal cortices of the brain.ConclusionThis study indicated that continuous infusion of combined DEX and remifentanil could be an effective strategy for anesthesia induction. The EEG during the induction was similar to the physiological sleep process. |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-09T17:11:03Z |
| publishDate | 2023-04-01 |
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| series | Frontiers in Medicine |
| spelling | doaj.art-0c102365552a47f88b96069e3f6eacd02023-04-20T05:54:59ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-04-011010.3389/fmed.2023.11580851158085Determination of the effective dose of dexmedetomidine to achieve loss of consciousness during anesthesia inductionBing Mu0Wenjie Xu1Hongyi Li2Zizheng Suo3Xiaoxiao Wang4Yuxiang Zheng5Yi Tian6Bowen Zhang7Jie Yu8Naiyuan Tian9Nan Lin10Dan Zhao11Zhaoxu Zheng12Hui Zheng13Cheng Ni14Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaClinical Epidemiology Research Center, Peking University Third Hospital, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Gynecology Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaBackgroundDexmedetomidine (DEX) is a sedative with greater preservation of cognitive function, reduced respiratory depression, and improved patient arousability. This study was designed to investigate the performance of DEX during anesthesia induction and to establish an effective DEX induction strategy, which could be valuable for multiple clinical conditions.MethodsPatients undergoing abdominal surgery were involved in this dose-finding trial. Dixon's up-and-down sequential method was employed to determine the effective dose of DEX to achieve the state of “loss of consciousness”, and an effective induction strategy was established with continuous infusion of DEX and remifentanil. The effects of DEX on hemodynamics, respiratory state, EEG, and anesthetic depth were monitored and analyzed.ResultsThrough the strategy mentioned, the depth of surgical anesthesia was successfully achieved by DEX-led anesthesia induction. The ED50 and ED95 of the initial infusion rate of DEX were 0.115 and 0.200 μg/kg/min, respectively, and the mean induction time was 18.3 min. The ED50 and ED95 of DEX to achieve the state of “loss of consciousness” were 2.899 (95% CI: 2.703–3.115) and 5.001 (95% CI: 4.544–5.700) μg/kg, respectively. The mean PSI on the loss of consciousness was 42.8 among the patients. During anesthesia induction, the hemodynamics including BP and HR were stable, and the EEG monitor showed decreased α and β powers and increased θ and δ in the frontal and pre-frontal cortices of the brain.ConclusionThis study indicated that continuous infusion of combined DEX and remifentanil could be an effective strategy for anesthesia induction. The EEG during the induction was similar to the physiological sleep process.https://www.frontiersin.org/articles/10.3389/fmed.2023.1158085/fulldexmedetomidineanesthesia inductioneffective doseelectroencephalogrampatient state index |
| spellingShingle | Bing Mu Wenjie Xu Hongyi Li Zizheng Suo Xiaoxiao Wang Yuxiang Zheng Yi Tian Bowen Zhang Jie Yu Naiyuan Tian Nan Lin Dan Zhao Zhaoxu Zheng Hui Zheng Cheng Ni Determination of the effective dose of dexmedetomidine to achieve loss of consciousness during anesthesia induction Frontiers in Medicine dexmedetomidine anesthesia induction effective dose electroencephalogram patient state index |
| title | Determination of the effective dose of dexmedetomidine to achieve loss of consciousness during anesthesia induction |
| title_full | Determination of the effective dose of dexmedetomidine to achieve loss of consciousness during anesthesia induction |
| title_fullStr | Determination of the effective dose of dexmedetomidine to achieve loss of consciousness during anesthesia induction |
| title_full_unstemmed | Determination of the effective dose of dexmedetomidine to achieve loss of consciousness during anesthesia induction |
| title_short | Determination of the effective dose of dexmedetomidine to achieve loss of consciousness during anesthesia induction |
| title_sort | determination of the effective dose of dexmedetomidine to achieve loss of consciousness during anesthesia induction |
| topic | dexmedetomidine anesthesia induction effective dose electroencephalogram patient state index |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1158085/full |
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