Intraoperative effect of dexmedetomidine infusion during living donor liver transplantation: A randomized control trial
Background: Dexmedetomidine hydrochloride (Dex) is a useful adjuvant for general anesthesia. The aim was to evaluate the effects of Dex infusion during living donors liver transplantation (LDLT) on the general anesthetic requirements, hemodynamics, oxygen consumption (VO 2 ), and CO 2 production (VC...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Saudi Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2016;volume=10;issue=3;spage=288;epage=294;aulast=Sayed |
| _version_ | 1818541621754462208 |
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| author | E Sayed K A Yassen |
| author_facet | E Sayed K A Yassen |
| author_sort | E Sayed |
| collection | DOAJ |
| description | Background: Dexmedetomidine hydrochloride (Dex) is a useful adjuvant for general anesthesia. The aim was to evaluate the effects of Dex infusion during living donors liver transplantation (LDLT) on the general anesthetic requirements, hemodynamics, oxygen consumption (VO 2 ), and CO 2 production (VCO 2 ).
Materials and Methods: Forty LDLT recipients were allocated randomly to receive either Dex (0.2-0.7 μg/kg/h) or placebo (control [C]). Patient state index (PSI), SEDLine monitored anesthesia depth (25-50) with desflurane (Des) % and fentanyl altered accordingly. Transesophageal Doppler (TED), invasive mean arterial blood pressure (MAP) and heart rate (HR) were monitoring any Dex side effects and altering infusion rate accordingly; TED was used for fluid optimization. Metabolic gas monitoring (VO 2 , VCO 2 ) and Des consumption were recorded.
Results: Dex reduced Des and fentanyl consumption versus C (120.0 ± 30.2 vs. 248.0 ± 38.8) ml, (440.0 ± 195.74 vs. 1300.0 ± 32) μg, respectively (P < 0.01). Dex was delivered for 11.35 ± 2.45 h with comparable HR, MAP, and TED variables versus C and with similar mean noradrenaline support (5.63 ± 2.44 vs. 5.83 ± 2.57 mg, P = 0.81). VO 2 was reduced with Dex vs. C during anhepatic, 30 min postreperfusion and end of surgery (193.2 ± 26.78 vs. 239 ± 14.93) (172.1 ± 28.14 vs. 202.7 ± 18.03) and (199.7 ± 26.63 vs. 283.8 ± 14.83) ml/min/m 2 respectively (P < 0.01). VCO 2 was also reduced with Dex versus C during the same periods (195.2 ± 46.41 vs. 216.7 ± 29.90, P = 0.09), (210.6 ± 60.71 vs. 253.9 ± 32.51, P = 0.01), and (158.7 ± 49.96 vs. 209.7 ± 16.78, P < 0.01), ml/min/m 2 respectively.
Conclusion: TED and PSI guided Dex infusion helped to reduce Des and fentanyl consumption as well as VO 2 and VCO 2 at a lower cost with no adverse effects on hemodynamics. |
| first_indexed | 2024-12-11T22:11:40Z |
| format | Article |
| id | doaj.art-182fd5ceeb9a431c9843759ed7d0e0c7 |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-12-11T22:11:40Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-182fd5ceeb9a431c9843759ed7d0e0c72022-12-22T00:48:45ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2016-01-0110328829410.4103/1658-354X.174914Intraoperative effect of dexmedetomidine infusion during living donor liver transplantation: A randomized control trialE SayedK A YassenBackground: Dexmedetomidine hydrochloride (Dex) is a useful adjuvant for general anesthesia. The aim was to evaluate the effects of Dex infusion during living donors liver transplantation (LDLT) on the general anesthetic requirements, hemodynamics, oxygen consumption (VO 2 ), and CO 2 production (VCO 2 ). Materials and Methods: Forty LDLT recipients were allocated randomly to receive either Dex (0.2-0.7 μg/kg/h) or placebo (control [C]). Patient state index (PSI), SEDLine monitored anesthesia depth (25-50) with desflurane (Des) % and fentanyl altered accordingly. Transesophageal Doppler (TED), invasive mean arterial blood pressure (MAP) and heart rate (HR) were monitoring any Dex side effects and altering infusion rate accordingly; TED was used for fluid optimization. Metabolic gas monitoring (VO 2 , VCO 2 ) and Des consumption were recorded. Results: Dex reduced Des and fentanyl consumption versus C (120.0 ± 30.2 vs. 248.0 ± 38.8) ml, (440.0 ± 195.74 vs. 1300.0 ± 32) μg, respectively (P < 0.01). Dex was delivered for 11.35 ± 2.45 h with comparable HR, MAP, and TED variables versus C and with similar mean noradrenaline support (5.63 ± 2.44 vs. 5.83 ± 2.57 mg, P = 0.81). VO 2 was reduced with Dex vs. C during anhepatic, 30 min postreperfusion and end of surgery (193.2 ± 26.78 vs. 239 ± 14.93) (172.1 ± 28.14 vs. 202.7 ± 18.03) and (199.7 ± 26.63 vs. 283.8 ± 14.83) ml/min/m 2 respectively (P < 0.01). VCO 2 was also reduced with Dex versus C during the same periods (195.2 ± 46.41 vs. 216.7 ± 29.90, P = 0.09), (210.6 ± 60.71 vs. 253.9 ± 32.51, P = 0.01), and (158.7 ± 49.96 vs. 209.7 ± 16.78, P < 0.01), ml/min/m 2 respectively. Conclusion: TED and PSI guided Dex infusion helped to reduce Des and fentanyl consumption as well as VO 2 and VCO 2 at a lower cost with no adverse effects on hemodynamics.http://www.saudija.org/article.asp?issn=1658-354X;year=2016;volume=10;issue=3;spage=288;epage=294;aulast=SayedAdult living donor liver transplantation; dexmedetomidine; intraoperative; recipient |
| spellingShingle | E Sayed K A Yassen Intraoperative effect of dexmedetomidine infusion during living donor liver transplantation: A randomized control trial Saudi Journal of Anaesthesia Adult living donor liver transplantation; dexmedetomidine; intraoperative; recipient |
| title | Intraoperative effect of dexmedetomidine infusion during living donor liver transplantation: A randomized control trial |
| title_full | Intraoperative effect of dexmedetomidine infusion during living donor liver transplantation: A randomized control trial |
| title_fullStr | Intraoperative effect of dexmedetomidine infusion during living donor liver transplantation: A randomized control trial |
| title_full_unstemmed | Intraoperative effect of dexmedetomidine infusion during living donor liver transplantation: A randomized control trial |
| title_short | Intraoperative effect of dexmedetomidine infusion during living donor liver transplantation: A randomized control trial |
| title_sort | intraoperative effect of dexmedetomidine infusion during living donor liver transplantation a randomized control trial |
| topic | Adult living donor liver transplantation; dexmedetomidine; intraoperative; recipient |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2016;volume=10;issue=3;spage=288;epage=294;aulast=Sayed |
| work_keys_str_mv | AT esayed intraoperativeeffectofdexmedetomidineinfusionduringlivingdonorlivertransplantationarandomizedcontroltrial AT kayassen intraoperativeeffectofdexmedetomidineinfusionduringlivingdonorlivertransplantationarandomizedcontroltrial |