Combined use of dexmedetomidine and propofol in monitored anesthesia care: a randomized controlled study

BMC Anesthesiology

Research Article

Hee Jong Lee¹  Soo Yeon Kim¹  Kyu Nam Kim¹  Ji Yoon Kim¹ 

[1] Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, 222, Wangsimni-ro, Seongdonggu, 133-792, Seoul, Republic of Korea;

关键词: Combination drug therapy;    Deep sedation;    Dexmedetomidine;    Propofol;   

DOI  :  10.1186/s12871-017-0311-9

 received in 2016-10-05, accepted in 2017-01-23,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroudAlthough propofol and dexmedetomidine have been widely used for monitored anesthesia care, their adverse effects necessitate the search for better methods. Therefore, we performed this randomized controlled trial to evaluate the combined use of propofol and dexmedetomidine.MethodsEighty-seven adult patients undergoing hand surgery under brachial plexus block were randomly allocated to receive 1.6 μg/ml of the target effect site concentration of propofol (P group) and infusion of 0.4 μg/kg/h dexmedetomidine following a loading dose of 1.0 μg/kg for 10 min (D group). The M group received a half-dose of both drugs simultaneously. The maintenance dose was adjusted to maintain an Observer Assessment of Alertness/Sedation score of 3. Cardiorespiratory variables, adverse effects, and drug efficacy were observed.ResultsThe significantly higher mean arterial pressure (mmHg) in the D group [P group 86.9 (12.6), D group 96.0 (12.2), M group 85.6 (10.6), p = 0.004)] and a significantly higher heart rate (beat/min) in the P group were observed [P group 67.3 (9.0), D group 57.8 (6.9), M group 59.2 (7.4), p < 0.001)]. The M group had a significant lower incidence of airway obstruction (p < 0.001) and the D group had a higher incidence of bradycardia requiring atropine (p = 0.001). The P group had higher incidences of hypoxia (p = 0.001), spontaneous movement (p < 0.001) and agitation (p = 0.001). The satisfaction scores of the patients (p = 0.007) and surgeon (p < 0.001) were higher in the M group. Onset time was significantly longer in the D group (p < 0.001).ConclusionsThe combined use of propofol and dexmedetomidine provided cardiovascular stability with decreased adverse effects. Additionally, it led to a similar onset time of propofol and achieved higher satisfaction scores.Trial registrationKCT0001284. Retrospectively registered 25 November 2014.

【 授权许可】

CC BY   
© The Author(s). 2017