Dexmedetomidina intravenosa, no midazolam, prolonga la anestesia espinal con bupivacaína
Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia.
Kaya FN, Yavascaoglu B, Turker G, Yildirim A, Gurbet A, Mogol EB, Ozcan B.
Department of Anesthesiology and Reanimation, Uludag University Medical School, Bursa, Turkey. fnurkaya@gmail.com
Can J Anaesth. 2010 Jan;57(1):39-45. doi: 10.1007/s12630-009-9231-6. Epub 2009 Dec 29.
Abstract
PURPOSE: Midazolam has only sedative properties. However, dexmedetomidine has both analgesic and sedative properties that may prolong the duration of sensory and motor block obtained with spinal anesthesia. This study was designed to compare intravenous dexmedetomidine with midazolam and placebo on spinal block duration, analgesia, and sedation in patients undergoing transurethral resection of the prostate. METHODS: In this double-blind randomized placebo-controlled trial, 75 American Society of Anesthesiologists' I and II patients receiveddexmedetomidine 0.5 microg . kg(-1), midazolam 0.05 mg . kg(-1), or saline intravenously before spinal anesthesia with bupivacaine 0.5% 15 mg (n = 25 per group). The maximum upper level of sensory block and sensory and motor regression times were recorded. Postoperative analgesic requirements and sedation were also recorded. RESULTS: Sensory block was higher with dexmedetomidine (T 4.6 +/- 0.6) than with midazolam (T 6.4 +/- 0.9; P < 0.001) or saline (T 6.4 +/- 0.8; P < 0.001). Time for sensory regression of two dermatomes was 145 +/- 26 min in the dexmedetomidine group, longer (P < 0.001) than in the midazolam (106 +/- 39 min) or the saline (97 +/- 27 min) groups. Duration of motor block was similar in all groups. Dexmedetomidine also increased the time to first request for postoperative analgesia (P < 0.01 compared with midazolam and saline) and decreased analgesic requirements (P < 0.05). The maximum Ramsay sedation score was greater in the dexmedetomidine and midazolam groups than in the saline group (P < 0.001). CONCLUSION:Intravenous dexmedetomidine, but not midazolam, prolonged spinal bupivacaine sensory blockade. It also provided sedation and additional analgesia.
http://download.springer.com/static/pdf/458/art%253A10.1007%252Fs12630-009-9231-6.pdf?auth66=1385441877_0696e43323b6e09951982ad82a143e36&ext=.pdf
Efecto de la suplementación de dosis bajas de dexmedetomidina i.v. sobre las características de la raquia con bupivacaína hiperbárica
Effect of supplementation of low dose intravenous dexmedetomidine on characteristics of spinal anaesthesia withhyperbaric bupivacaine.
Harsoor S, Rani DD, Yalamuru B, Sudheesh K, Nethra S.
Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.
Indian J Anaesth. 2013 May;57(3):265-9. doi: 10.4103/0019-5049.115616.
Abstract
AIMS:Intravenous (IV) dexmedetomidine with excellent sedative properties has been shown to reduce analgesic requirements during generalanaesthesia. A study was conducted to assess the effects of IV dexmedetomidine on sensory, motor, haemodynamic parameters and sedation during subarachnoid block (SAB). METHODS:A total of 50 patients undergoing infraumbilical and lower limb surgeries under SAB were selected. Group D received IV dexmedetomidine0.5 mcg/kg bolus over 10 min prior to SAB, followed by an infusion of 0.5 mcg/kg/h for the duration of the surgery. Group C received similar volume of normal saline infusion. Time for the onset of sensory and motor blockade, cephalad level of analgesia and duration of analgesia were noted. Sedation scores using Ramsay Sedation Score (RSS) and haemodynamic parameters were assessed. RESULTS: Demographic parameters, duration and type of surgery were comparable. Onset of sensory block was 66±44.14 s in Group D compared with 129.6±102.4 s in Group C. The time for two segment regression was 111.52±30.9 min in Group D and 53.6±18.22 min in Group C and duration of analgesia was 222.8±123.4 min in Group D and 138.36±21.62 min in Group C. The duration of motor blockade was prolonged in Group D compared with Group C. There was clinically and statistically significant decrease in heart rate and blood pressures in Group D. The mean intraoperative RSS was higher in Group D. CONCLUSION: Administration of IV dexmedetomidine during SAB hastens the onset of sensory block and prolongs the duration of sensory and motor block with satisfactory arousable sedation.
KEYWORDS:Dexmedetomidine, intravenous, subarachnoid block, supplementation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748681/
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2013;volume=57;issue=3;spage=265;epage=269;aulast=Harsoor;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia.
Kaya FN, Yavascaoglu B, Turker G, Yildirim A, Gurbet A, Mogol EB, Ozcan B.
Department of Anesthesiology and Reanimation, Uludag University Medical School, Bursa, Turkey. fnurkaya@gmail.com
Can J Anaesth. 2010 Jan;57(1):39-45. doi: 10.1007/s12630-009-9231-6. Epub 2009 Dec 29.
Abstract
PURPOSE: Midazolam has only sedative properties. However, dexmedetomidine has both analgesic and sedative properties that may prolong the duration of sensory and motor block obtained with spinal anesthesia. This study was designed to compare intravenous dexmedetomidine with midazolam and placebo on spinal block duration, analgesia, and sedation in patients undergoing transurethral resection of the prostate. METHODS: In this double-blind randomized placebo-controlled trial, 75 American Society of Anesthesiologists' I and II patients receiveddexmedetomidine 0.5 microg . kg(-1), midazolam 0.05 mg . kg(-1), or saline intravenously before spinal anesthesia with bupivacaine 0.5% 15 mg (n = 25 per group). The maximum upper level of sensory block and sensory and motor regression times were recorded. Postoperative analgesic requirements and sedation were also recorded. RESULTS: Sensory block was higher with dexmedetomidine (T 4.6 +/- 0.6) than with midazolam (T 6.4 +/- 0.9; P < 0.001) or saline (T 6.4 +/- 0.8; P < 0.001). Time for sensory regression of two dermatomes was 145 +/- 26 min in the dexmedetomidine group, longer (P < 0.001) than in the midazolam (106 +/- 39 min) or the saline (97 +/- 27 min) groups. Duration of motor block was similar in all groups. Dexmedetomidine also increased the time to first request for postoperative analgesia (P < 0.01 compared with midazolam and saline) and decreased analgesic requirements (P < 0.05). The maximum Ramsay sedation score was greater in the dexmedetomidine and midazolam groups than in the saline group (P < 0.001). CONCLUSION:Intravenous dexmedetomidine, but not midazolam, prolonged spinal bupivacaine sensory blockade. It also provided sedation and additional analgesia.
http://download.springer.com/static/pdf/458/art%253A10.1007%252Fs12630-009-9231-6.pdf?auth66=1385441877_0696e43323b6e09951982ad82a143e36&ext=.pdf
Efecto de la suplementación de dosis bajas de dexmedetomidina i.v. sobre las características de la raquia con bupivacaína hiperbárica
Effect of supplementation of low dose intravenous dexmedetomidine on characteristics of spinal anaesthesia withhyperbaric bupivacaine.
Harsoor S, Rani DD, Yalamuru B, Sudheesh K, Nethra S.
Department of Anaesthesiology, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.
Indian J Anaesth. 2013 May;57(3):265-9. doi: 10.4103/0019-5049.115616.
Abstract
AIMS:Intravenous (IV) dexmedetomidine with excellent sedative properties has been shown to reduce analgesic requirements during generalanaesthesia. A study was conducted to assess the effects of IV dexmedetomidine on sensory, motor, haemodynamic parameters and sedation during subarachnoid block (SAB). METHODS:A total of 50 patients undergoing infraumbilical and lower limb surgeries under SAB were selected. Group D received IV dexmedetomidine0.5 mcg/kg bolus over 10 min prior to SAB, followed by an infusion of 0.5 mcg/kg/h for the duration of the surgery. Group C received similar volume of normal saline infusion. Time for the onset of sensory and motor blockade, cephalad level of analgesia and duration of analgesia were noted. Sedation scores using Ramsay Sedation Score (RSS) and haemodynamic parameters were assessed. RESULTS: Demographic parameters, duration and type of surgery were comparable. Onset of sensory block was 66±44.14 s in Group D compared with 129.6±102.4 s in Group C. The time for two segment regression was 111.52±30.9 min in Group D and 53.6±18.22 min in Group C and duration of analgesia was 222.8±123.4 min in Group D and 138.36±21.62 min in Group C. The duration of motor blockade was prolonged in Group D compared with Group C. There was clinically and statistically significant decrease in heart rate and blood pressures in Group D. The mean intraoperative RSS was higher in Group D. CONCLUSION: Administration of IV dexmedetomidine during SAB hastens the onset of sensory block and prolongs the duration of sensory and motor block with satisfactory arousable sedation.
KEYWORDS:Dexmedetomidine, intravenous, subarachnoid block, supplementation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748681/
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2013;volume=57;issue=3;spage=265;epage=269;aulast=Harsoor;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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