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The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative sedation. Anesth Analg 2002 Aug;95(2):461-6, table of contents

Date

07/30/2002

Pubmed ID

12145072

DOI

10.1097/00000539-200208000-00042

Scopus ID

2-s2.0-0036078051 (requires institutional sign-in at Scopus site)   272 Citations

Abstract

UNLABELLED: We evaluated the cardio-respiratory effects of equi-sedative doses of dexmedetomidine and propofol for intraoperative sedation. Secondary comparison end points were time to achieve and terminate sedation and postoperative analgesia and psychomotor performance. Forty patients scheduled for elective surgery provided informed consent and were randomized equally to receive either dexmedetomidine (1 microg/kg initial loading dose for 10 min; maintenance, 0.4-0.7 microg. kg(-1). h(-1)) or propofol (75 microg. kg(-1). min(-1) x 10 min; maintenance, 12.5-75 microg. kg(-1). min(-1)). Hemodynamic variables (heart rate and mean arterial blood pressure), sedation (visual analog scale and Observer Assessment of Alertness/Sedation), bispectral index score of sedation, ventilation (respiratory rate, O2 sat, and ETCO2), psychomotor performance (digital symbol substitution test), and pain (visual analog scale) were determined during surgery and up to 95 min after surgery. Intraoperative sedation levels were targeted to achieve a bispectral index score of 70-80. Patient demographics, ASA class, surgical procedure, and baseline cardio-respiratory variables were similar between groups. Sedation was achieved more rapidly with propofol but was similar between groups 25 min after initiating infusions. The average infusion rate for dexmedetomidine was 0.7 microg. kg(-1). h(-1) and 38 microg. kg(-1). min(-1) for propofol. There were no differences between groups in psychomotor performance and respiratory rate during recovery. The previous use of dexmedetomidine resulted in more sedation, lower blood pressure, and improved analgesia (less morphine use) in recovery.

IMPLICATIONS: Dexmedetomidine may be useful for perioperative sedation. It has a slower onset and offset of sedation compared with propofol. Dexmedetomidine was associated with improved analgesia and less morphine use in the postoperative period.

Author List

Arain SR, Ebert TJ

Author

Thomas J. Ebert MD, PhD Adjunct Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Anesthesia Recovery Period
Conscious Sedation
Dexmedetomidine
Double-Blind Method
Elective Surgical Procedures
Female
Hemodynamics
Humans
Hypnotics and Sedatives
Intraoperative Period
Male
Middle Aged
Pain, Postoperative
Postoperative Nausea and Vomiting
Propofol
Psychomotor Performance
Respiratory Function Tests