PMID- 15648981
OWN - NLM
STAT- MEDLINE
DCOM- 20050331
LR  - 20220408
IS  - 0310-057X (Print)
IS  - 0310-057X (Linking)
VI  - 32
IP  - 6
DP  - 2004 Dec
TI  - Dexmedetomidine infusion without loading dose in surgical patients requiring 
      mechanical ventilation: haemodynamic effects and efficacy.
PG  - 741-5
AB  - We investigated the haemodynamic effects and the efficacy of a continuous 
      infusion of dexmedetomidine without a loading dose in 50 patients having had 
      cardiac surgery (n = 33), complex major surgery (n = 9) and multiple trauma (n = 
      8). The mean age was 60 (+/- 16) years, and the mean APACHE II score was 13 (+/- 
      5). Dexmedetomidine was commenced at an initial rate of 0.2 to 0.4 microg/kg/h 
      (depending on whether anaesthetic or sedative agents had already been used) and 
      rescue analgesia and sedation was administered with morphine and midazolam 
      respectively. Propofol was used if additional sedation was needed. Sedation was 
      targeted to a modified Motor Activity Assessment Score. Eighty percent of 
      patients required no or "minimal" rescue therapy (< 10 mg midazolam/day and/or < 
      10 mg morphine/day and/or < 100 mg propofol/day). The cardiac surgery group 
      needed the least rescue therapy. A statistically significant but clinically 
      unimportant reduction in mean heart rate and mean systolic blood pressure was 
      observed over the first six hours (P < 0.0001, and P = 0.009 respectively). The 
      baseline heart rate of 85 (+/- 17) beats per minute (bpm), fell to a low of 78 
      (+/- 13) bpm at four hours and then remained stable throughout the infusion 
      period. The systolic blood pressure fell from 125 (+/- 22) mmHg to a low of 112 
      (+/- 20) mmHg at 1.5 hours with minimal change afterwards. Dexmedetomidine was an 
      effective sedative and analgesic in this group of complex surgical and trauma 
      patients with pronounced benefit in the cardiac surgery group. Omitting the 
      loading dose avoided undesirable haemodynamic effects without compromising 
      sedation and analgesia.
FAU - Ickeringill, M
AU  - Ickeringill M
AD  - Prince of Wales Hospital, Intensive Care Unit, Randwick, New South Wales.
FAU - Shehabi, Y
AU  - Shehabi Y
FAU - Adamson, H
AU  - Adamson H
FAU - Ruettimann, U
AU  - Ruettimann U
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Anaesth Intensive Care
JT  - Anaesthesia and intensive care
JID - 0342017
RN  - 0 (Hypnotics and Sedatives)
RN  - 67VB76HONO (Dexmedetomidine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Analysis of Variance
MH  - Cardiac Surgical Procedures
MH  - Chi-Square Distribution
MH  - Dexmedetomidine/*administration & dosage
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Female
MH  - Follow-Up Studies
MH  - Hemodynamics/*drug effects
MH  - Humans
MH  - Hypnotics and Sedatives/*administration & dosage
MH  - Infusions, Intravenous
MH  - Male
MH  - Maximum Tolerated Dose
MH  - Middle Aged
MH  - Multiple Trauma/diagnosis/*drug therapy/surgery
MH  - Pain, Postoperative/*drug therapy/therapy
MH  - Probability
MH  - Prospective Studies
MH  - Respiration, Artificial
MH  - Risk Assessment
MH  - Sampling Studies
MH  - Statistics, Nonparametric
MH  - Surgical Procedures, Operative
EDAT- 2005/01/15 09:00
MHDA- 2005/04/01 09:00
CRDT- 2005/01/15 09:00
PHST- 2005/01/15 09:00 [pubmed]
PHST- 2005/04/01 09:00 [medline]
PHST- 2005/01/15 09:00 [entrez]
AID - 2004035 [pii]
AID - 10.1177/0310057X0403200602 [doi]
PST - ppublish
SO  - Anaesth Intensive Care. 2004 Dec;32(6):741-5. doi: 10.1177/0310057X0403200602.