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Effect of intraoperative Dexmedetomidine infusion on Sevoflurane requirement and blood glucose levels during entropy-guided general anesthesia.

Harsoor SS, Rani DD, Lathashree S, Nethra SS, Sudheesh K - J Anaesthesiol Clin Pharmacol (2014)

Bottom Line: In peri-operative period, the heart rate and MAP were significantly lower in Group D, when compared to placebo.Patients in Group D were better sedated and post-operative pain score was better in Group D compared to Group P.IV Dexmedetomidine was effective in blunting stress response to surgical trauma as indicated by lower blood glucose levels, and reduces Sevoflurane requirements during entropy guided general anesthesia without affecting time for extubation.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesia, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.

ABSTRACT

Background: Dexmedetomidine has been shown to blunt the stress response to surgery. Hence a study was designed to evaluate the effect of intravenous (IV) Dexmedetomidine infusion during general anesthesia for abdominal surgeries on blood glucose levels and on Sevoflurane requirements during anesthesia.

Materials and methods: Forty patients scheduled for abdominal surgery under general anesthesia were divided into Dexmedetomidine (D) group and Placebo (P) group of 20 each. Group D received a loading dose of Inj. Dexmedetomidine at 1 μg/kg/10 min diluted to 20 mL, followed by maintenance with 0.5 μg/kg/h., till the end of surgery. Group P received similar volume of IV normal saline. Anesthesia was maintained with nitrous oxide in oxygen and Sevoflurane keeping entropy between 40 and 60. Data were analyzed using students t test, chi square test and Fisher Exact test as applicable.

Results: During the first postoperative hour, Dexmedetomidine group showed blood glucose levels of 118.2 ± 16.24 mg/dL, compared to placebo group which was 136.95 ± 19.76 mg/dL and it was statistically significant (P < 0.01). Mean hourly Sevoflurane requirement in Group D was 11.10 ± 2.17 mL, compared to 15.45 ± 3.97 mL in placebo group. In peri-operative period, the heart rate and MAP were significantly lower in Group D, when compared to placebo. Patients in Group D were better sedated and post-operative pain score was better in Group D compared to Group P.

Conclusion: IV Dexmedetomidine was effective in blunting stress response to surgical trauma as indicated by lower blood glucose levels, and reduces Sevoflurane requirements during entropy guided general anesthesia without affecting time for extubation.

No MeSH data available.


Related in: MedlinePlus

Graph showing comparison of heart rate between the groups. Heart rate was significantly low in group D
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Figure 1: Graph showing comparison of heart rate between the groups. Heart rate was significantly low in group D

Mentions: There was a clinically and statistically significant reduction in heart rate (HR) in group D throughout intraoperative period compared to group P (P < 0.05) [Figure 1]. Bradycardia was noticed in 3 out of 20 patients in group D, which was treated with inj. Atropine 0.6 mg IV. There was no incidence of bradycardia in group P. However, there was no statistically significant difference in systolic and diastolic blood pressures and also the MAP were comparable in both groups during intraoperative period.


Effect of intraoperative Dexmedetomidine infusion on Sevoflurane requirement and blood glucose levels during entropy-guided general anesthesia.

Harsoor SS, Rani DD, Lathashree S, Nethra SS, Sudheesh K - J Anaesthesiol Clin Pharmacol (2014)

Graph showing comparison of heart rate between the groups. Heart rate was significantly low in group D
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927287&req=5

Figure 1: Graph showing comparison of heart rate between the groups. Heart rate was significantly low in group D
Mentions: There was a clinically and statistically significant reduction in heart rate (HR) in group D throughout intraoperative period compared to group P (P < 0.05) [Figure 1]. Bradycardia was noticed in 3 out of 20 patients in group D, which was treated with inj. Atropine 0.6 mg IV. There was no incidence of bradycardia in group P. However, there was no statistically significant difference in systolic and diastolic blood pressures and also the MAP were comparable in both groups during intraoperative period.

Bottom Line: In peri-operative period, the heart rate and MAP were significantly lower in Group D, when compared to placebo.Patients in Group D were better sedated and post-operative pain score was better in Group D compared to Group P.IV Dexmedetomidine was effective in blunting stress response to surgical trauma as indicated by lower blood glucose levels, and reduces Sevoflurane requirements during entropy guided general anesthesia without affecting time for extubation.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesia, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India.

ABSTRACT

Background: Dexmedetomidine has been shown to blunt the stress response to surgery. Hence a study was designed to evaluate the effect of intravenous (IV) Dexmedetomidine infusion during general anesthesia for abdominal surgeries on blood glucose levels and on Sevoflurane requirements during anesthesia.

Materials and methods: Forty patients scheduled for abdominal surgery under general anesthesia were divided into Dexmedetomidine (D) group and Placebo (P) group of 20 each. Group D received a loading dose of Inj. Dexmedetomidine at 1 μg/kg/10 min diluted to 20 mL, followed by maintenance with 0.5 μg/kg/h., till the end of surgery. Group P received similar volume of IV normal saline. Anesthesia was maintained with nitrous oxide in oxygen and Sevoflurane keeping entropy between 40 and 60. Data were analyzed using students t test, chi square test and Fisher Exact test as applicable.

Results: During the first postoperative hour, Dexmedetomidine group showed blood glucose levels of 118.2 ± 16.24 mg/dL, compared to placebo group which was 136.95 ± 19.76 mg/dL and it was statistically significant (P < 0.01). Mean hourly Sevoflurane requirement in Group D was 11.10 ± 2.17 mL, compared to 15.45 ± 3.97 mL in placebo group. In peri-operative period, the heart rate and MAP were significantly lower in Group D, when compared to placebo. Patients in Group D were better sedated and post-operative pain score was better in Group D compared to Group P.

Conclusion: IV Dexmedetomidine was effective in blunting stress response to surgical trauma as indicated by lower blood glucose levels, and reduces Sevoflurane requirements during entropy guided general anesthesia without affecting time for extubation.

No MeSH data available.


Related in: MedlinePlus