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The effects of DEX premedication on volatile induction of mask anesthesia (VIMA) and sevoflurane requirements

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Abstract

We investigated the effect of intravenous premedication with single dose of dexmedetomidine (DEX) on volatile anesthetic induction time and sevoflurane requirements of anesthesia maintenance in adults by monitoring the bispectral index (BIS). Sixty adult patients with status of ASA I–II undergoing general anesthesia with endotracheal intubation were randomly divided into two groups: The first group; a control group (group C, n = 30) and the second group; DEX group (group D, n = 30). Each patient in group D was premedicated with intravenous DEX 0.5 μg/kg or placebo 10 min before the induction of anesthesia. Anesthesia was induced by fentanyl 1 μg/kg, 1:1 ratio of nitrous oxide and oxygen and sevoflurane of 5–8 % and rocuronium bromur (Esmeron) 0.5 mg/kg keeping BIS values at 40–50. Time to induction of anesthesia, BIS, End-tidal sevoflurane concentration (Etsevoflurane), End-tidal CO2 concentration, duration of surgery, recovery time, hemodynamic variables, adverse effects were recorded intraoperatively. Analgesic requirement was noted in postoperative 24 h-period. The time to induction of anesthesia (p < 0.0001) and Etsevoflurane at 1 min (p < 0.05) were significantly lower in group D than in group C. Intravenous premedication with 0.5 μg/kg of DEX decreased the induction time by almost 75 % and provided a significant decrease in Etsevoflurane.

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References

  1. Yurino M, Kimura H. A comparison of vital capacity breath and tidal breathing techniques for induction of anaesthesia with high sevoflurane concentrations in nitrous oxide and oxygen. Anaesthesia. 1995;50:308–11.

    Article  PubMed  CAS  Google Scholar 

  2. Hall JE, Stewart JI, Harmer M. Single-breath inhalation induction of sevoflurane anaesthesia with and without nitrous oxide: a feasibility study in adults and comparison with an intravenous bolus of propofol. Anaesthesia. 1997;52:410–5.

    Article  PubMed  CAS  Google Scholar 

  3. Hattori J, Yamakage M, Iwasaki S, et al. Usefulness of midazolam premedication for volatile induction of anesthesia in adults. J Anesth. 2001;15:117–9.

    Article  PubMed  CAS  Google Scholar 

  4. Yamakage M, Tsuchiya S, Ohtsuka N, Iwasaki S, Namiki A. Usefulness of oral hypnotic premedication for volatile induction of anesthesia in adults. J Anesth. 2002;16:194–7.

    Article  PubMed  Google Scholar 

  5. Lamberty JM, Wilson IH. Single breath induction of anaesthesia with isoflurane. Br J Anaesth. 1987;59:1214–8.

    Article  PubMed  CAS  Google Scholar 

  6. Ruffle JM, Snider MT, Rosenberger JL, Latta WB. Rapid induction of halothane anaesthesia in man. Br J Anaesth. 1985;57:607–11.

    Article  PubMed  CAS  Google Scholar 

  7. Ruffle JM, Snider MT. Comparison of rapid and conventional inhalation inductions of halothane oxygen anesthesia in healthy men and women. Anesthesiology. 1987;67:584–7.

    Article  PubMed  CAS  Google Scholar 

  8. Strum DP, Eger EI 2nd. Partition coefficients for sevoflurane in human blood, saline, and olive oil. Anesth Analg. 1987;66:654–6.

    PubMed  CAS  Google Scholar 

  9. Scheller MS, Saidman LJ, Partridge BL. MAC of sevoflurane in humans and the New Zealand white rabbit. Can J Anaesth. 1988;35:153–6.

    Article  PubMed  CAS  Google Scholar 

  10. Taguchi M, Watanabe S, Asakura N, Inomata S. End-tidal sevoflurane concentrations for laryngeal mask airway insertion and for tracheal intubation in children. Anesthesiology. 1994;81:628–31.

    Article  PubMed  CAS  Google Scholar 

  11. Kimura T, Watanabe S, Asakura N, et al. Determination of end-tidal sevoflurane concentration for tracheal intubation and minimum alveolar anesthetic concentration in adults. Anesth Analg. 1994;79:378–81.

    Article  PubMed  CAS  Google Scholar 

  12. Yurino M, Kimura H. Vital capacity rapid inhalation induction technique: comparison of sevoflurane and halothane. Can J Anaesth. 1993;40:440–3.

    Article  PubMed  CAS  Google Scholar 

  13. Maze M, Tranquilli W. Alpha-2 adrenoceptor agonists: defining the role in clinical anesthesia. Anesthesiology. 1991;74:581–605.

    Article  PubMed  CAS  Google Scholar 

  14. Salonen MA, Kanto JH, Maze M. Clinical interactions with alpha-2-adrenergic agonists in anesthetic practice. J Clin Anesth. 1992;4:164–72.

    Article  PubMed  CAS  Google Scholar 

  15. Inomata S, Yaguchi Y, Toyooka H. The effects of clonidine premedication on sevoflurane requirements and anesthetic induction time. Anesth Analg. 1999;89:204–8.

    PubMed  CAS  Google Scholar 

  16. Aantaa RE, Kanto JH, Scheinin M, Kallio AM, Scheinin H. Dexmedetomidine premedication for minor gynecologic surgery. Anesth Analg. 1990;70:407–13.

    Article  PubMed  CAS  Google Scholar 

  17. Scheinin B, Lindgren L, Randell T, Scheinin H, Scheinin M. Dexmedetomidine attenuates sympathoadrenal responses to tracheal intubation and reduces the need for thiopentone and peroperative fentanyl. Br J Anaesth. 1992;68:126–31.

    Article  PubMed  CAS  Google Scholar 

  18. Buhrer M, Mappes A, Lauber R, Stanski DR, Maitre PO. Dexmedetomidine decreases thiopental dose requirement and alters distribution pharmacokinetics. Anesthesiology. 1994;80:1216–27.

    Article  PubMed  CAS  Google Scholar 

  19. Aantaa R, Jaakola ML, Kallio A, Kanto J. Reduction of the minimum alveolar concentration of isoflurane by dexmedetomidine. Anesthesiology. 1997;86:1055–60.

    Article  PubMed  CAS  Google Scholar 

  20. Katoh T, Suzuki A, Ikeda K. Electroencephalographic derivatives as a tool for predicting the depth of sedation and anesthesia induced by sevoflurane. Anesthesiology. 1998;88:642–50.

    Article  PubMed  CAS  Google Scholar 

  21. Sigl JC, Chamoun NG. An introduction to bispectral analysis for the electroencephalogram. J Clin Monit. 1994;10:392–404.

    Article  PubMed  CAS  Google Scholar 

  22. Song D, Joshi GP, White PF. Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia. Anesthesiology. 1997;87:842–8.

    Article  PubMed  CAS  Google Scholar 

  23. Bonhomme V, Hans P. Monitoring the depth of anaesthesia: why, how and at which cost? Rev Med Liege. 2007;62 Spec No:33–9.

    Google Scholar 

  24. Correa-Sales C, Rabin BC, Maze M. A hypnotic response to dexmedetomidine, an alpha 2 agonist, is mediated in the locus coeruleus in rats. Anesthesiology. 1992;76:948–52.

    Article  PubMed  CAS  Google Scholar 

  25. Correa-Sales C, Nacif-Coelho C, Reid K, Maze M. Inhibition of adenylate cyclase in the locus coeruleus mediates the hypnotic response to an alpha 2 agonist in the rat. J Pharmacol Exp Ther. 1992;263:1046–9.

    PubMed  CAS  Google Scholar 

  26. Maksimow A, Snapir A, Sarkela M, et al. Assessing the depth of dexmedetomidine-induced sedation with electroencephalogram (EEG)-based spectral entropy. Acta Anaesthesiol Scand. 2007;51:22–30.

    Article  PubMed  CAS  Google Scholar 

  27. Ghignone M, Quintin L, Duke PC, Kehler CH, Calvillo O. Effects of clonidine on narcotic requirements and hemodynamic response during induction of fentanyl anesthesia and endotracheal intubation. Anesthesiology. 1986;64:36–42.

    Article  PubMed  CAS  Google Scholar 

  28. Ghignone M, Calvillo O, Quintin L. Anesthesia and hypertension: the effect of clonidine on perioperative hemodynamics and isoflurane requirements. Anesthesiology. 1987;67:3–10.

    Article  PubMed  CAS  Google Scholar 

  29. Kaukinen S, Pyykko K. The potentiation of halothane anaesthesia by clonidine. Acta Anaesthesiol Scand. 1979;23:107–11.

    Article  PubMed  CAS  Google Scholar 

  30. Levanen J, Makela ML, Scheinin H. Dexmedetomidine premedication attenuates ketamine-induced cardiostimulatory effects and postanesthetic delirium. Anesthesiology. 1995;82:1117–25.

    Article  PubMed  CAS  Google Scholar 

  31. Tobias JD, Berkenbosch JW. Sedation during mechanical ventilation in infants and children: dexmedetomidine versus midazolam. South Med J. 2004;97:451–5.

    Article  PubMed  Google Scholar 

  32. 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.

    Article  PubMed  CAS  Google Scholar 

  33. Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Proc (Bayl Univ Med Cent). 2001;14:13–21.

    CAS  Google Scholar 

  34. Siau C, Liu EH. Nitrous oxide does not improve sevoflurane induction of anesthesia in adults. J Clin Anesth. 2002;14:218–22.

    Article  PubMed  CAS  Google Scholar 

  35. Tufanogullari B, White PF, Peixoto MP, et al. Dexmedetomidine infusion during laparoscopic bariatric surgery: the effect on recovery outcome variables. Anesth Analg. 2008;106:1741–8.

    Article  PubMed  CAS  Google Scholar 

  36. Salmenpera MT, Szlam F, Hug CC Jr. Anesthetic and hemodynamic interactions of dexmedetomidine and fentanyl in dogs. Anesthesiology. 1994;80:837–46.

    Article  PubMed  CAS  Google Scholar 

  37. Rabin BC, Reid K, Guo TZ, et al. Sympatholytic and minimum anesthetic concentration-sparing responses are preserved in rats rendered tolerant to the hypnotic and analgesic action of dexmedetomidine, a selective alpha(2)-adrenergic agonist. Anesthesiology. 1996;85:565–73.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, Gaziantep University Medical Faculty, School of Medicine, Gaziantep University, 27310, Sahinbey, Gaziantep, Turkey

    Ayse Mizrak, Suleyman Ganidagli, Mehri T. Cengiz, Unsal Oner & Vahap Saricicek

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  1. Ayse Mizrak
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  2. Suleyman Ganidagli
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  3. Mehri T. Cengiz
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  4. Unsal Oner
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  5. Vahap Saricicek
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Correspondence to Ayse Mizrak.

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Mizrak, A., Ganidagli, S., Cengiz, M.T. et al. The effects of DEX premedication on volatile induction of mask anesthesia (VIMA) and sevoflurane requirements. J Clin Monit Comput 27, 329–334 (2013). https://doi.org/10.1007/s10877-013-9440-y

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  • DOI: https://doi.org/10.1007/s10877-013-9440-y

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