PMID- 24692763
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140402
LR  - 20220317
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 68
IP  - 5
DP  - 2007 Sep
TI  - Effect of Dexmedetomidine IV on the Duration of Spinal Anesthesia with 
      Prilocaine: A Double-Blind, Prospective Study in Adult Surgical Patients.
PG  - 313-24
LID - 10.1016/j.curtheres.2007.10.006 [doi]
AB  - BACKGROUND: The duration of spinal anesthesia with prilocaine has been poorly 
      documented and no English-language study has been published regarding the effects 
      of dexmedetomidine on the duration of anesthesia with spinal prilocaine. 
      OBJECTIVE: The aim of this study was to assess the effects of dexmedetomidine IV 
      on the duration of action of prilocaine and its associated adverse events (AEs) 
      in spinal anesthesia. METHODS: In this double-blind, prospective study, patients 
      classified as American Society of Anesthesiologists grade I to II who were to 
      undergo lower abdominal, anorectal, or extremity surgery with a spinal anesthetic 
      were assigned to 1 of 2 groups. All patients were administered prilocaine 2% for 
      spinal anesthesia. Within 10 minutes after spinal anesthesia was initiated, group 
      1 received a loading dose of dexmedetomidine 1 mug/kg IV, followed by a 
      maintenance dose of 0.4 mug/kg . h for 50 minutes; group 2 (control) received the 
      same amount of physiologic saline in the same time frame. Mean arterial pressure 
      (MAP), heart rate (HR), duration of sensory and motor blockade, and sedation 
      scores were tracked. Patients were observed for 4.5 hours after surgery, with 
      follow-ups occurring up to 96 hours after surgery. RESULTS: Eighty-three patients 
      were assessed for study inclusion, 23 of whom were excluded. Sixty patients (42 
      men, 18 women; mean [SD] age, 40.56 [16.86] years) were included in the study. 
      MAP was similar in the 2 groups throughout the study. Mean (SD) HR was 
      significantly lower in group 1 compared with group 2 at 20 minutes (70.43 [19.28] 
      vs 77.63 [18.14] beats per minute, respectively; P = 0.02). The mean (SD) 
      duration of the persistence of sensory anesthesia (ie, the time required for the 
      maximal level of anesthesia to regress 2 dermatomes) was significantly longer in 
      group 1 compared with group 2 (148.33 [21.18] vs 122.83 [18.73] minutes; P < 
      0.001). The mean (SD) time to complete abolishment of motor blockade was also 
      significantly longer in group 1 than in group 2 (215.16 [25.10] vs 190.83 [18.57] 
      minutes; P < 0.001). The average sedation score in group 1 was significantly 
      higher than in group 2 (P < 0.001) during anesthesia. Significantly more patients 
      in group 1 required atropine than those in group 2 (9 vs 2 patients; P < 0.001) 
      to treat bradycardia. There was no significant between-group difference in the 
      number of patients who received ephedrine to treat hypotension. One patient in 
      each group reported waist and back pain; 2 patients in each group reported 
      nausea. Shivering occurred in 0 and 5 patients in groups 1 and 2, respectively; 
      the between-group difference in AEs was not statistically significant. 
      Paresthesia, postdural puncture headache, allergic reactions, total spinal 
      anesthesia, urinary retention, or vomiting-AEs commonly associated with spinal 
      anesthesia-were not observed or reported by either group. CONCLUSIONS: The 
      results of this study suggest that dexmedetomidine IV significantly prolonged the 
      duration of spinal anesthesia and provided a significantly higher level of 
      sedation compared to placebo in this group of adult surgical patients. The 
      treatment was generally well tolerated in all patients.
FAU - Tekin, Murat
AU  - Tekin M
AD  - Department of Anesthesiology and Reanimation, Yuzuncu Yil University, Van, 
      Turkey.
FAU - Kati, Ismail
AU  - Kati I
AD  - Department of Anesthesiology and Reanimation, Yuzuncu Yil University, Van, 
      Turkey.
FAU - Tomak, Yakup
AU  - Tomak Y
AD  - Department of Anesthesiology and Reanimation, Yuzuncu Yil University, Van, 
      Turkey.
FAU - Kisli, Erol
AU  - Kisli E
AD  - Department of General Surgery, Yuzuncu Yil University, Van, Turkey.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3969905
OTO - NOTNLM
OT  - dexmedetomidine
OT  - prilocaine
OT  - spinal anesthesia
EDAT- 2007/09/01 00:00
MHDA- 2007/09/01 00:01
PMCR- 2007/09/01
CRDT- 2014/04/03 06:00
PHST- 2007/04/12 00:00 [accepted]
PHST- 2014/04/03 06:00 [entrez]
PHST- 2007/09/01 00:00 [pubmed]
PHST- 2007/09/01 00:01 [medline]
PHST- 2007/09/01 00:00 [pmc-release]
AID - S0011-393X(07)00087-2 [pii]
AID - 10.1016/j.curtheres.2007.10.006 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2007 Sep;68(5):313-24. doi: 
      10.1016/j.curtheres.2007.10.006.