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Dexmedetomidine versus propofol for sedation in patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia.

Ghali A, Mahfouz AK, Ihanamäki T, El Btarny AM - Saudi J Anaesth (2011)

Bottom Line: Both groups provided a similar significant reduction in heart rate and mean arterial pressure compared with baseline values.The respiratory rate values of the dexmedetomidine group were significantly higher than those in the propofol group.Dexmedetomidine at similar sedation levels with propofol was associated with equivalent hemodynamic effects, maintaining an adequate respiratory function, similar time of discharge from PACU, better analgesic properties, similar surgeon's satisfaction, and higher patient's satisfaction.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Magrabi Eye & Ear Hospital, Muscat, Sultanate of Oman.

ABSTRACT

Purpose: The purpose of this study was to evaluate the hemodynamic, respiratory effects, the recovery profile, surgeons, and patients satisfaction with dexmedetomidine sedation compared with those of propofol sedation in patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia.

Methods: Sixty patients were enrolled in this prospective, single-blind, randomized study. The patients were divided into two groups to receive either dexmedetomidine (group D) or propofol (group P). Sedation level was titrated to a Ramsay sedation scale (RSS) of 3. Hemodynamic and respiratory effects, postoperative recovery time, analgesic effects, surgeons and patients satisfaction were assessed.

Results: Both groups provided a similar significant reduction in heart rate and mean arterial pressure compared with baseline values. The respiratory rate values of the dexmedetomidine group were significantly higher than those in the propofol group. The oxygen saturation values of the dexmedetomidine group were significantly higher than those of the propofol group. The expired CO(2) was similar in both groups. Postoperatively, the time to achieve an Aldrete score of 10 was similar in both groups. Dexmedetomidine patients have significantly lower visual analog scale for pain than propofol patients. The surgeon satisfaction with patients' sedation was similar for both groups. The patients' satisfaction was higher in the dexmedetomidine group.

Conclusion: Dexmedetomidine at similar sedation levels with propofol was associated with equivalent hemodynamic effects, maintaining an adequate respiratory function, similar time of discharge from PACU, better analgesic properties, similar surgeon's satisfaction, and higher patient's satisfaction. Thus, dexmedetomidine may prove to be a valuable adjuvant for sedation in patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia.

No MeSH data available.


Related in: MedlinePlus

Levels of RSS during the intraoperative period (sedation period). Data are displayed as means±standard deviations. *Statistically significant compared to the baseline value. †Statistically significant compared to group D.
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Figure 0002: Levels of RSS during the intraoperative period (sedation period). Data are displayed as means±standard deviations. *Statistically significant compared to the baseline value. †Statistically significant compared to group D.

Mentions: The two groups were comparable with respect to the following variables; age, sex, weight, ASA status, and duration of surgery (P>0.05). The time required from the start of the infusion of the study drugs to achieve targeted levels of sedation was significantly longer in the dexmedetomidine group (20.36±4.66 min) than in the propofol group (10.96±3.27 min) (P=0.001) [Table 2]. However, there was no significant difference in the RSS levels throughout the sedation period in both groups [Figure 2]. In both groups, there were a similar significant reduction in HR and MAP compared with baseline values (P>0.05). Furthermore, the RR values in the dexmedetomidine group were significantly increased (P<0.05) compared with baseline values, while there was significant reduction in the RR in the propofol group (P<0.05) compared with baseline values. RR values in the dexmedetomidine group were significantly higher than those in the propofol group during the sedation period (P<0.05). The SpaO2 values in the dexmedetomidine group did not change from baseline, while there was significant reduction in the SpaO2 in the propofol group (P<0.05) compared with the baseline values. SpaO2 values in the dexmedetomidine group were significantly higher than those in the propofol group during the sedation period (P<0.05). The expired CO2 was similar in both groups (P>0.05) [Figure 3]. In the immediate postoperative period, all the cardiorespiratory measures returned back to the normal preoperative values within 15 min. Nevertheless, there were no episodes of bradycardia, hypotension, desaturation, nausea and vomiting, or dry mouth in either group.


Dexmedetomidine versus propofol for sedation in patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia.

Ghali A, Mahfouz AK, Ihanamäki T, El Btarny AM - Saudi J Anaesth (2011)

Levels of RSS during the intraoperative period (sedation period). Data are displayed as means±standard deviations. *Statistically significant compared to the baseline value. †Statistically significant compared to group D.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3101751&req=5

Figure 0002: Levels of RSS during the intraoperative period (sedation period). Data are displayed as means±standard deviations. *Statistically significant compared to the baseline value. †Statistically significant compared to group D.
Mentions: The two groups were comparable with respect to the following variables; age, sex, weight, ASA status, and duration of surgery (P>0.05). The time required from the start of the infusion of the study drugs to achieve targeted levels of sedation was significantly longer in the dexmedetomidine group (20.36±4.66 min) than in the propofol group (10.96±3.27 min) (P=0.001) [Table 2]. However, there was no significant difference in the RSS levels throughout the sedation period in both groups [Figure 2]. In both groups, there were a similar significant reduction in HR and MAP compared with baseline values (P>0.05). Furthermore, the RR values in the dexmedetomidine group were significantly increased (P<0.05) compared with baseline values, while there was significant reduction in the RR in the propofol group (P<0.05) compared with baseline values. RR values in the dexmedetomidine group were significantly higher than those in the propofol group during the sedation period (P<0.05). The SpaO2 values in the dexmedetomidine group did not change from baseline, while there was significant reduction in the SpaO2 in the propofol group (P<0.05) compared with the baseline values. SpaO2 values in the dexmedetomidine group were significantly higher than those in the propofol group during the sedation period (P<0.05). The expired CO2 was similar in both groups (P>0.05) [Figure 3]. In the immediate postoperative period, all the cardiorespiratory measures returned back to the normal preoperative values within 15 min. Nevertheless, there were no episodes of bradycardia, hypotension, desaturation, nausea and vomiting, or dry mouth in either group.

Bottom Line: Both groups provided a similar significant reduction in heart rate and mean arterial pressure compared with baseline values.The respiratory rate values of the dexmedetomidine group were significantly higher than those in the propofol group.Dexmedetomidine at similar sedation levels with propofol was associated with equivalent hemodynamic effects, maintaining an adequate respiratory function, similar time of discharge from PACU, better analgesic properties, similar surgeon's satisfaction, and higher patient's satisfaction.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Magrabi Eye & Ear Hospital, Muscat, Sultanate of Oman.

ABSTRACT

Purpose: The purpose of this study was to evaluate the hemodynamic, respiratory effects, the recovery profile, surgeons, and patients satisfaction with dexmedetomidine sedation compared with those of propofol sedation in patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia.

Methods: Sixty patients were enrolled in this prospective, single-blind, randomized study. The patients were divided into two groups to receive either dexmedetomidine (group D) or propofol (group P). Sedation level was titrated to a Ramsay sedation scale (RSS) of 3. Hemodynamic and respiratory effects, postoperative recovery time, analgesic effects, surgeons and patients satisfaction were assessed.

Results: Both groups provided a similar significant reduction in heart rate and mean arterial pressure compared with baseline values. The respiratory rate values of the dexmedetomidine group were significantly higher than those in the propofol group. The oxygen saturation values of the dexmedetomidine group were significantly higher than those of the propofol group. The expired CO(2) was similar in both groups. Postoperatively, the time to achieve an Aldrete score of 10 was similar in both groups. Dexmedetomidine patients have significantly lower visual analog scale for pain than propofol patients. The surgeon satisfaction with patients' sedation was similar for both groups. The patients' satisfaction was higher in the dexmedetomidine group.

Conclusion: Dexmedetomidine at similar sedation levels with propofol was associated with equivalent hemodynamic effects, maintaining an adequate respiratory function, similar time of discharge from PACU, better analgesic properties, similar surgeon's satisfaction, and higher patient's satisfaction. Thus, dexmedetomidine may prove to be a valuable adjuvant for sedation in patients undergoing vitreoretinal surgery under sub-Tenon's anesthesia.

No MeSH data available.


Related in: MedlinePlus