Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trial
Background and Aims: The study was conceived to elucidate the effects of dexmedetomidine as an anesthetic adjunct to propofol (total intravenous anesthesia) on anesthetic dose reduction and anesthesia recovery parameters in cerebello-pontine angle (CPA) surgeries. Material and Methods: This prospect...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Journal of Anaesthesiology Clinical Pharmacology |
| Subjects: | |
| Online Access: | http://www.joacp.org/article.asp?issn=0970-9185;year=2018;volume=34;issue=4;spage=496;epage=502;aulast=Chakrabarti |
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| author | Dhritiman Chakrabarti Sriganesh Kamath K R Madhusudan Reddy Deepti B Srinivas Nitin Manohar Dheeraj Masapu |
| author_facet | Dhritiman Chakrabarti Sriganesh Kamath K R Madhusudan Reddy Deepti B Srinivas Nitin Manohar Dheeraj Masapu |
| author_sort | Dhritiman Chakrabarti |
| collection | DOAJ |
| description | Background and Aims: The study was conceived to elucidate the effects of dexmedetomidine as an anesthetic adjunct to propofol (total intravenous anesthesia) on anesthetic dose reduction and anesthesia recovery parameters in cerebello-pontine angle (CPA) surgeries.
Material and Methods: This prospective randomized study was conducted on 49 patients (25 with dexmedetomidine, 24 without). After standardized anesthetic induction, anesthesia was maintained using propofol (via target controlled infusion, titrated to maintain BIS between 40 and 60), fentanyl (0.5 μg/kg/hour) and either dexmedetomidine (0.5 μg/kg/hour) or a sham infusion. Neuromuscular blocking agents were excluded to allow cranial nerve EMG monitoring. Adverse hemodynamic events, recovery parameters (time to opening eyes, obeying commands, and extubation) and postoperative sedation score, shivering score, nausea, and vomiting score were recorded.
Results: Propofol and fentanyl utilization (as total dose, adjusted for duration of surgery and body weight, and number of extra boluses) was significantly lower in the dexmedetomidine group. There was no difference in any of the recovery parameters between the two groups. Incidence of bradycardia was significantly higher with dexmedetomidine, while no difference was found for hypotension, hypertension, and tachycardia.
Conclusion: Dexmedetomidine–fentanyl–propofol anesthesia compares favorably with fentanyl–propofol anesthesia during CPA neurosurgical procedures with regard to anesthesia recovery times, but with lower intraoperative opioid and hypnotic utilization rates. |
| first_indexed | 2024-12-10T22:48:39Z |
| format | Article |
| id | doaj.art-7c0392a8c28644129aae860c12ea787a |
| institution | Directory Open Access Journal |
| issn | 0970-9185 |
| language | English |
| last_indexed | 2024-12-10T22:48:39Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj.art-7c0392a8c28644129aae860c12ea787a2022-12-22T01:30:30ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852018-01-0134449650210.4103/joacp.JOACP_55_18Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trialDhritiman ChakrabartiSriganesh KamathK R Madhusudan ReddyDeepti B SrinivasNitin ManoharDheeraj MasapuBackground and Aims: The study was conceived to elucidate the effects of dexmedetomidine as an anesthetic adjunct to propofol (total intravenous anesthesia) on anesthetic dose reduction and anesthesia recovery parameters in cerebello-pontine angle (CPA) surgeries. Material and Methods: This prospective randomized study was conducted on 49 patients (25 with dexmedetomidine, 24 without). After standardized anesthetic induction, anesthesia was maintained using propofol (via target controlled infusion, titrated to maintain BIS between 40 and 60), fentanyl (0.5 μg/kg/hour) and either dexmedetomidine (0.5 μg/kg/hour) or a sham infusion. Neuromuscular blocking agents were excluded to allow cranial nerve EMG monitoring. Adverse hemodynamic events, recovery parameters (time to opening eyes, obeying commands, and extubation) and postoperative sedation score, shivering score, nausea, and vomiting score were recorded. Results: Propofol and fentanyl utilization (as total dose, adjusted for duration of surgery and body weight, and number of extra boluses) was significantly lower in the dexmedetomidine group. There was no difference in any of the recovery parameters between the two groups. Incidence of bradycardia was significantly higher with dexmedetomidine, while no difference was found for hypotension, hypertension, and tachycardia. Conclusion: Dexmedetomidine–fentanyl–propofol anesthesia compares favorably with fentanyl–propofol anesthesia during CPA neurosurgical procedures with regard to anesthesia recovery times, but with lower intraoperative opioid and hypnotic utilization rates.http://www.joacp.org/article.asp?issn=0970-9185;year=2018;volume=34;issue=4;spage=496;epage=502;aulast=ChakrabartiBispectral indexcerebello-pontine angledexmedetomidine |
| spellingShingle | Dhritiman Chakrabarti Sriganesh Kamath K R Madhusudan Reddy Deepti B Srinivas Nitin Manohar Dheeraj Masapu Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trial Journal of Anaesthesiology Clinical Pharmacology Bispectral index cerebello-pontine angle dexmedetomidine |
| title | Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trial |
| title_full | Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trial |
| title_fullStr | Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trial |
| title_full_unstemmed | Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trial |
| title_short | Effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during Bispectral Index-guided anesthesia for cerebello-pontine angle surgeries: A randomized clinical trial |
| title_sort | effect of adjunctive dexmedetomidine on anesthesia and analgesia requirement and recovery characteristics during bispectral index guided anesthesia for cerebello pontine angle surgeries a randomized clinical trial |
| topic | Bispectral index cerebello-pontine angle dexmedetomidine |
| url | http://www.joacp.org/article.asp?issn=0970-9185;year=2018;volume=34;issue=4;spage=496;epage=502;aulast=Chakrabarti |
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