Access the full text.
Sign up today, get DeepDyve free for 14 days.
O. Olutoye, Chris Glover, John Diefenderfer, Michael McGilberry, Matthew Wyatt, D. Larrier, E. Friedman, M. Watcha (2010)
The Effect of Intraoperative Dexmedetomidine on Postoperative Analgesia and Sedation in Pediatric Patients Undergoing Tonsillectomy and AdenoidectomyAnesthesia & Analgesia, 111
R. Link, K. Desai, L. Hein, M. Stevens, A. Chruscinski, D. Bernstein, G. Barsh, B. Kobilka (1996)
Cardiovascular Regulation in Mice Lacking α2-Adrenergic Receptor Subtypes b and cScience, 273
S. Kassam, Chao Lu, Norman Buckley, R. Lee (2011)
The Mechanisms of Propofol-Induced Vascular Relaxation and Modulation by Perivascular Adipose Tissue and EndotheliumAnesthesia & Analgesia, 112
Sheridan Hoy, G. Keating (2011)
DexmedetomidineDrugs, 71
Ian Chan, Jurgen Maslany, Kyle Gorman, Jennifer O’Brien, W. McKay (2016)
Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trialCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 63
S. Arain, T. Ebert (2002)
The Efficacy, Side Effects, and Recovery Characteristics of Dexmedetomidine Versus Propofol When Used for Intraoperative SedationAnesthesia & Analgesia, 95
D. Höhener, S. Blumenthal, Alain Borgeat (2008)
Sedation and regional anaesthesia in the adult patient.British journal of anaesthesia, 100 1
Hongxing Zhang, F. Zhou, Chen Li, Min Kong, He Liu, Peng Zhang, Song Zhang, Junli Cao, Licai Zhang, Hong Ma (2013)
Molecular Mechanisms Underlying the Analgesic Property of Intrathecal Dexmedetomidine and Its Neurotoxicity Evaluation: An In Vivo and In Vitro Experimental StudyPLoS ONE, 8
K. Jie, P. Brummelen, P. Vermey, P. Timmermans, P. Zwieten (1984)
Identification of vascular postsynaptic alpha 1- and alpha 2-adrenoceptors in man.Circulation research, 54 4
M. Philipp, M. Brede, L. Hein (2002)
Physiological significance of alpha(2)-adrenergic receptor subtype diversity: one receptor is not enough.American journal of physiology. Regulatory, integrative and comparative physiology, 283 2
N. Vadivelu, S. Mitra, E. Schermer, Vijay Kodumudi, A. Kaye, R. Urman (2014)
Preventive analgesia for postoperative pain control: a broader conceptLocal and Regional Anesthesia, 7
B. Robinson, Thomas Ebert, T. O'Brien, Maelynn Colinco, M. Muzi (1997)
Mechanisms whereby Propofol Mediates Peripheral Vasolidation in Humans: Sympathoinhibition or Direct Vascular Relaxation?Anesthesiology, 86
E. Rosero, G. Joshi (2014)
Preemptive, Preventive, Multimodal Analgesia: What Do They Really Mean?Plastic and Reconstructive Surgery, 134
J. Alhashemi (2006)
Dexmedetomidine vs midazolam for monitored anaesthesia care during cataract surgery.British journal of anaesthesia, 96 6
D. Ge, Bin Qi, Gang Tang, Jin-yu Li (2015)
Intraoperative Dexmedetomidine Promotes Postoperative Analgesia and Recovery in Patients after Abdominal ColectomyMedicine, 94
D. Ge, Bin Qi, Gang Tang, Jin-yu Li (2016)
Intraoperative Dexmedetomidine Promotes Postoperative Analgesia and Recovery in Patients after Abdominal Hysterectomy: a Double-Blind, Randomized Clinical TrialScientific Reports, 6
Dominic Carollo, B. Nossaman, U. Ramadhyani (2008)
Dexmedetomidine: a review of clinical applicationsCurrent Opinion in Anaesthesiology, 21
V. Athanassoglou, Anna Wallis, S. Galitzine (2015)
Audiovisual distraction as a useful adjunct to epidural anesthesia and sedation for prolonged lower limb microvascular orthoplastic surgery.Journal of clinical anesthesia, 27 7
F. Abdallah, A. Abrishami, R. Brull (2013)
The Facilitatory Effects of Intravenous Dexmedetomidine on the Duration of Spinal Anesthesia: A Systematic Review and Meta-AnalysisAnesthesia & Analgesia, 117
Mi-hyun Kim, F. Nahm, T. Kim, M. Chang, S. Do (2014)
Comparison of postoperative pain in the first and second knee in staged bilateral total knee arthroplasty: Clinical evidence of enhanced pain sensitivity after surgical injuryPAIN®, 155
R. Gertler, H. Brown, D. Mitchell, Erin Silvius (2001)
Dexmedetomidine: A Novel Sedative-Analgesic AgentBaylor University Medical Center Proceedings, 14
J. Gross, P. Bailey, Richard Connis, C. Coté, F. Davis, B. Epstein, L. Gilbertson, JohnM. Zerwas, J. Arens (2002)
Practice Guidelines for Sedation and Analgesia by Non-AnesthesiologistsAnesthesiology, 96
Welcome Guimera (2005)
Practice Guidelines for Sedation and Analgesia by Non- Anesthesiologists
K. Kaygusuz, G. Gokce, S. Gursoy, S. Ayan, C. Mimaroğlu, Yener Gultekin (2008)
A Comparison of Sedation with Dexmedetomidine or Propofol During Shockwave Lithotripsy: A Randomized Controlled TrialAnesthesia & Analgesia, 106
BACKGROUND: In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol. METHODS: Forty-eight patients were enrolled and randomly assigned to either a dexmedetomidine group (n = 24), which received a loading dose of 1 μg/kg dexmedetomidine over 10 minutes, followed by a continuous infusion of 0.1–0.5 μg·kg−1·hour−1, or a propofol group (n = 24), which received a continuous infusion of propofol via a target-controlled infusion to maintain the effect-site concentration within a range of 0.5–2.0 μg/mL. The drug infusion rate was determined according to the sedation level, targeting a modified observer’s assessment of alertness/sedation score of 3 or 4. The cumulative amounts of fentanyl administered via intravenous patient-controlled analgesia were recorded at 24 and 48 hours postoperatively (primary outcome). The postoperative numerical rating scale for pain was assessed at 6, 12, 24, and 48 hours (secondary outcome). The postoperative use of additional rescue analgesic (ketoprofen) and antiemetic drugs was also compared between the 2 groups at 24 and 48 hours. RESULTS: Dexmedetomidine significantly reduced postoperative fentanyl consumption (median [interquartile range]) during 0–24 hours (45 [30–71] vs 150 [49–248] μg, P = .004; median difference = −105 μg [99.98% CI, 210–7.5]), 24–48 hours (90 [45–143] vs 188 [75–266] μg, P = .005; median difference = −98 μg [99.98% CI, 195–45]), and 0–48 hours (135 [68–195] vs 360 [146–480] μg, P = .003; median difference = −225 μg [99.98% CI, 405–7.5]). The numerical rating scale (median [interquartile range]) was lower at 6 hours (1 [0–2] vs 2 [1–3], P = .003), 12 hours (1 [1–2] vs 3 [2–3], P < .001), 24 hours (1 [1–2] vs 3 [2–3], P < .001), and 48 hours (2 [2–3] vs 3 [3–4], P < .001) after surgery in the dexmedetomidine group compared to the propofol group. No significant intergroup differences were observed in the amount of rescue analgesics and antiemetics at 24 hours (P = .155 and P = .482) and 48 hours (P = .082 and P = .153) after surgery. CONCLUSIONS: Intraoperative dexmedetomidine sedation was associated with a small but clinically important reduction in postoperative opioid use after total knee arthroplasty.
Anesthesia & Analgesia – Wolters Kluwer Health
Published: Dec 1, 2019
Read and print from thousands of top scholarly journals.
Already have an account? Log in
Bookmark this article. You can see your Bookmarks on your DeepDyve Library.
To save an article, log in first, or sign up for a DeepDyve account if you don’t already have one.
Copy and paste the desired citation format or use the link below to download a file formatted for EndNote
Access the full text.
Sign up today, get DeepDyve free for 14 days.
All DeepDyve websites use cookies to improve your online experience. They were placed on your computer when you launched this website. You can change your cookie settings through your browser.