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Published in: Journal of Anesthesia 3/2013

01-06-2013 | Original Article

The effects of single-dose intravenous dexmedetomidine on hyperbaric bupivacaine spinal anesthesia

Authors: Seung Hwan Jung, Soo Kyung Lee, Kyung Jee Lim, Eun Young Park, Mae Hwa Kang, Jung Min Lee, Jae Jun Lee, Sung Mi Hwang, Sung Jun Hong

Published in: Journal of Anesthesia | Issue 3/2013

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Abstract

Purpose

Dexmedetomidine, a selective α2-adrenoceptor agonist, has analgesic and sedative effects. The purpose of this study was to investigate the effects of small, single-dose intravenous dexmedetomidine administration after hyperbaric bupivacaine spinal anesthesia.

Methods

Sixty adult patients classified as American Society of Anesthesiologists physical status 1 or 2 and scheduled for lower extremity surgery under spinal anesthesia were studied. Patients were randomly assigned to one of three groups and administered hyperbaric intrathecal bupivacaine 12 mg. 5 min after spinal anesthesia, patients in groups 1, 2, and 3 received normal saline 10 ml, dexmedetomidine 0.25 μg/kg, and dexmedetomidine 0.5 μg/kg, respectively, over 10-min intravenous administration. The onset time, maximum block level, two-dermatome sensory regression time, duration of motor and sensory anesthesia, and side effects were assessed.

Results

The two-dermatome sensory regression time was significantly increased in groups 2 and 3. The duration of motor and sensory anesthesia was significantly increased in group 3. Onset time, maximum block level, level of sedation, and incidence of hypotension and treatment-needed bradycardia were no different among the groups.

Conclusion

Single-dose intravenous dexmedetomidine 0.25–0.5 μg/kg, administered 5 min after intrathecal injection of hyperbaric bupivacaine, improved the duration of spinal anesthesia without significant side effects. This method may be useful for increasing the duration of spinal anesthesia, even after intrathecal injection of local anesthetics.
Literature
1.
go back to reference Johnson JO, Grecu L, Lawson NW. Antonomic nervous system. In: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, editors. Clinical anesthesia. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 355. Johnson JO, Grecu L, Lawson NW. Antonomic nervous system. In: Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, editors. Clinical anesthesia. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 355.
2.
go back to reference Basar N, Akpinar S, Doganci N. Buyukkocak U, Kaymak C, Sert O, Apan A. The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters. J Clin Anesth. 2008;20:431–6. Basar N, Akpinar S, Doganci N. Buyukkocak U, Kaymak C, Sert O, Apan A. The effects of preanesthetic, single-dose dexmedetomidine on induction, hemodynamic, and cardiovascular parameters. J Clin Anesth. 2008;20:431–6.
3.
go back to reference Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesthesiol Scand. 2006;50:222–7.PubMedCrossRef Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesthesiol Scand. 2006;50:222–7.PubMedCrossRef
4.
go back to reference Kaya FN, Yavascaoglu B, Turker G, Yildirim A, Gurbet A, Mogol EB, Ozcan B. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Can J Anaesth. 2010;57:39–45.PubMedCrossRef Kaya FN, Yavascaoglu B, Turker G, Yildirim A, Gurbet A, Mogol EB, Ozcan B. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Can J Anaesth. 2010;57:39–45.PubMedCrossRef
5.
go back to reference Al-Mustafa MM, Badran IZ, Abu-Ali HM, Al-Barazangi BA, Massad IM, Al-Ghanem SM. Intravenous dexmedetomidine prolongs bupivacaine spinal analgesia. Middle East J Anesthesiol. 2009;20:225–31.PubMed Al-Mustafa MM, Badran IZ, Abu-Ali HM, Al-Barazangi BA, Massad IM, Al-Ghanem SM. Intravenous dexmedetomidine prolongs bupivacaine spinal analgesia. Middle East J Anesthesiol. 2009;20:225–31.PubMed
6.
go back to reference Elcicek K, Tekin M, Kati I. The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia. J Anesth. 2010;24:544–8.PubMedCrossRef Elcicek K, Tekin M, Kati I. The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia. J Anesth. 2010;24:544–8.PubMedCrossRef
7.
go back to reference Grant SA, Breslin DS, Macleod DB, Gleason D, Martin G. Dexmedetomidine infusion for sedation during fiberoptic intubation: a report of three cases. J Clin Anesth. 2004;16:124–6.PubMedCrossRef Grant SA, Breslin DS, Macleod DB, Gleason D, Martin G. Dexmedetomidine infusion for sedation during fiberoptic intubation: a report of three cases. J Clin Anesth. 2004;16:124–6.PubMedCrossRef
8.
go back to reference Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology. 1992;77:1134–42.PubMedCrossRef Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology. 1992;77:1134–42.PubMedCrossRef
9.
go back to reference Chernik DA, Gilling D, Laine H, Hendler J, Siler JM, Davidson AB, Schwam EM, Siegel JL. Validity and reliability of the Observer’s Assessment of Alertness/Sedation scale: study with intravenous midazolam. J Clin Psychopharmacol. 1990;10(244–51):126. Chernik DA, Gilling D, Laine H, Hendler J, Siler JM, Davidson AB, Schwam EM, Siegel JL. Validity and reliability of the Observer’s Assessment of Alertness/Sedation scale: study with intravenous midazolam. J Clin Psychopharmacol. 1990;10(244–51):126.
10.
go back to reference Kaabachi O, Zarghouni A, Ouezini R, Abdelaziz AB, Chattaoui O, Kokki H. Clonidine 1 microg/kg is a safe and effective adjuvant to plain bupivacaine in spinal anesthesia in adolescents. Anesth Analg. 2007;105:516–9.PubMedCrossRef Kaabachi O, Zarghouni A, Ouezini R, Abdelaziz AB, Chattaoui O, Kokki H. Clonidine 1 microg/kg is a safe and effective adjuvant to plain bupivacaine in spinal anesthesia in adolescents. Anesth Analg. 2007;105:516–9.PubMedCrossRef
11.
go back to reference Coskuner I, Tekin M, Kati I, Yagmur C, Elcicek K. Effects of dexmedetomidine on the duration of anaesthesia and wakefulness in bupivacaine epidural block. Eur J Anaesthesiol. 2007;24:535–40.PubMedCrossRef Coskuner I, Tekin M, Kati I, Yagmur C, Elcicek K. Effects of dexmedetomidine on the duration of anaesthesia and wakefulness in bupivacaine epidural block. Eur J Anaesthesiol. 2007;24:535–40.PubMedCrossRef
12.
go back to reference Kallio A, Scheinin M, Koulu M, Ponkilainen R, Ruskoaho H, Viinamäki O, Scheinin H. Effects of dexmedetomidine, a selective alpha 2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin Pharmacol Ther. 1989;46:33–42.PubMedCrossRef Kallio A, Scheinin M, Koulu M, Ponkilainen R, Ruskoaho H, Viinamäki O, Scheinin H. Effects of dexmedetomidine, a selective alpha 2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin Pharmacol Ther. 1989;46:33–42.PubMedCrossRef
13.
go back to reference Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000;93:382–94.PubMedCrossRef Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000;93:382–94.PubMedCrossRef
14.
go back to reference Jaakola ML, Salonen M, Lehtinen R, Scheinin H. The analgesia action of dexmedetomidine -a novel alpha 2-adrenoceptor agonist-in healthy volunteer. Pain. 1991;46:281–5.PubMedCrossRef Jaakola ML, Salonen M, Lehtinen R, Scheinin H. The analgesia action of dexmedetomidine -a novel alpha 2-adrenoceptor agonist-in healthy volunteer. Pain. 1991;46:281–5.PubMedCrossRef
15.
go back to reference Jorm CM, Stamford JA. Actions of the hypnotic anaesthetic, dexmedetomidine, on noradrenaline release and cell firing in rat locus coeruleus slices. Br J Anaesth. 1993;71:447–9.PubMedCrossRef Jorm CM, Stamford JA. Actions of the hypnotic anaesthetic, dexmedetomidine, on noradrenaline release and cell firing in rat locus coeruleus slices. Br J Anaesth. 1993;71:447–9.PubMedCrossRef
16.
go back to reference Calasans-Maia JA, Zapata-Sudo G, Sudo RT. Dexmedetomidine prolongs spinal anaesthesia induced by levobupivacaine 0.5% in guinea-pigs. J Pharm Pharmacol. 2005;57:1415–20.PubMedCrossRef Calasans-Maia JA, Zapata-Sudo G, Sudo RT. Dexmedetomidine prolongs spinal anaesthesia induced by levobupivacaine 0.5% in guinea-pigs. J Pharm Pharmacol. 2005;57:1415–20.PubMedCrossRef
17.
go back to reference Strahlendorf JC, Strahlendorf HK, Kingsley RE, Gintautas J, Barnes CD. Facilitation of lumbar monosynaptic reflexes by locus coeruleus stimulation. Neuropharmacology. 1980;19:225–300.PubMedCrossRef Strahlendorf JC, Strahlendorf HK, Kingsley RE, Gintautas J, Barnes CD. Facilitation of lumbar monosynaptic reflexes by locus coeruleus stimulation. Neuropharmacology. 1980;19:225–300.PubMedCrossRef
18.
go back to reference Brummett CM, Padda AK, Amodeo FS, Welch KB, Lydic R. Perineural dexmedetomidine added to ropivacaine causes a dose-dependent increase in the duration of thermal antinociception in sciatic nerve block in rat. Anesthesiology. 2009;111:1111–9.PubMedCrossRef Brummett CM, Padda AK, Amodeo FS, Welch KB, Lydic R. Perineural dexmedetomidine added to ropivacaine causes a dose-dependent increase in the duration of thermal antinociception in sciatic nerve block in rat. Anesthesiology. 2009;111:1111–9.PubMedCrossRef
Metadata
Title
The effects of single-dose intravenous dexmedetomidine on hyperbaric bupivacaine spinal anesthesia
Authors
Seung Hwan Jung
Soo Kyung Lee
Kyung Jee Lim
Eun Young Park
Mae Hwa Kang
Jung Min Lee
Jae Jun Lee
Sung Mi Hwang
Sung Jun Hong
Publication date
01-06-2013
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 3/2013
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-012-1541-0

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