Open AccessThe Hemodynamic and Adrenergic Effects of Perioperative Dexmedetomidine Infusion after Vascular Surgery
Author(s) -
Pekka Talke,
Richard Chen,
Brian Thomas,
Anil Aggarwall,
Alexandru Gottlieb,
Per Thorborg,
Stephen O. Heard,
Albert T. Cheung,
Stanley Lee Son,
Antero Kallio
Publication year - 2000
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1097/00000539-200004000-00011
Subject(s) - dexmedetomidine , medicine , anesthesia , heart rate , blood pressure , hemodynamics , norepinephrine , mean arterial pressure , perioperative , anesthetic , agonist , placebo , sedation , receptor , alternative medicine , pathology , dopamine
We tested dexmedetomidine, an alpha(2) agonist that decreases heart rate, blood pressure, and plasma norepinephrine concentration, for its ability to attenuate stress responses during emergence from anesthesia after major vascular operations. Patients scheduled for vascular surgery received either dexmedetomidine (n = 22) or placebo (n = 19) IV beginning 20 min before the induction of anesthesia and continuing until 48 h after the end of surgery. All patients received standardized anesthesia. Heart rate and arterial blood pressure were kept within predetermined limits by varying anesthetic level and using vasoactive medications. Heart rate, arterial blood pressure, and inhaled anesthetic concentration were monitored continuously; additional measurements included plasma and urine catecholamines. During emergence from anesthesia, heart rate was slower with dexmedetomidine (73 +/- 11 bpm) than placebo (83 +/- 20 bpm) (P = 0.006), and the percentage of time the heart rate was within the predetermined hemodynamic limits was more frequent with dexmedetomidine (P < 0.05). Plasma norepinephrine levels increased only in the placebo group and were significantly lower for the dexmedetomidine group during the immediate postoperative period (P = 0.0002). We conclude that dexmedetomidine attenuates increases in heart rate and plasma norepinephrine concentrations during emergence from anesthesia.