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Intramuscular dexmedetomidine premedication—an alternative to midazolam‐fentanyl‐combination in elective hysterectomy?
Author(s) -
JAAKOLA M.L.,
KANTO J.,
SCHEININ H.,
KALLIO A.
Publication year - 1994
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1994.tb03881.x
Subject(s) - medicine , anesthesia , fentanyl , dexmedetomidine , premedication , midazolam , sedation , tracheal intubation , heart rate , intubation , hysterectomy , placebo , blood pressure , surgery , alternative medicine , pathology
Sedation, anxiolysis, intubation responses and fentanyl anaesthetic requirements were investigated in a double‐blind, randomized study in twenty ASA I‐II elective hysterectomy patients. Ten patients received dexmedetomidine 2.5 μg kg ‐1 i.m. 60 min before induction and saline placebo i.v. 2 min prior to induction (= DP group). Ten patients received midazolam 0.08 mg kg ‐1 i.m. 60 min and fentanyl 1.5 μg kg ‐1 i.v. (= MF group) 2 min before induction of anaesthesia with thiopentone 4 mg kg ‐1 . Anaesthesia was maintained with 70% nitrous oxide in oxygen and with fentanyl 2 μg kg ‐1 i.v. increments according to predetermined criteria. Both premedications induced sedation ( P < 0.01 in both groups) and anxiolysis ( P < 0.01 in DP vs <0.05 in MF group) without any differences between the groups. Haemodynamic changes following tracheal intubation did not significantly differ between the groups. Intraoperatively systolic and diastolic arterial pressure were 15% and 13% lower in DP group ( P < 0.01 and P < 0.05 for drug effect), the mean heart rate was approximately 9 beats min ‐1 lower in DP group (n.s.). Fentanyl was required more often in MF group: median 3.5 (QD 1.5) vs. 2.5 (QD 0.5) times in DP group ( P < 0.05), the total amount being 57% smaller in DP group: 0.03 (QD 0.01) vs. 0.07 (QD 0.02) μg kg ‐1 min ‐1 ( P < 0.05). Postoperative course and analgesic requirements were similar in both groups. Dexmedetomidine premedication may offer an alternative to current anaesthesia practice in elective hysterectomy.