Skip to main content
Erschienen in: Journal of Anesthesia 4/2010

01.08.2010 | Original Article

The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia

verfasst von: Kamuran Elcıcek, Murat Tekın, Ismail Katı

Erschienen in: Journal of Anesthesia | Ausgabe 4/2010

Einloggen, um Zugang zu erhalten

Abstract

Purpose

In this study we investigated the effects of intravenously administered dexmedetomidine on the duration of hyperbaric ropivacaine in spinal anesthesia, and the side effects.

Methods

In a prospective, double-blind study, sixty ASA I-II patients were randomized to two groups of 30 individuals. All patients were administered hyperbaric ropivacaine (22.5 mg) for spinal anesthesia. Intravenous dexmedetomidine was administered in group I for 60 min, physiological saline at the same amount and duration was infused in group II.

Results

Measurements of mean blood pressure before and after the procedure revealed significant decreases in group I compared with group II after 20, 25, and 30 min. The times for two dermatomes regression of the blockade and complete resolution of motor blockade were significantly prolonged in group I. The sedation score in the dexmedetomidine group was significantly increased compared with controls. Atropine requirement was found to be significantly higher in group I than in group II.

Conclusion

Our results show that intravenously administered dexmedetomidine prolonged the duration of spinal anesthesia, provided sufficient sedation, and had few side effects. Therefore, dexmedetomidine is appropriate during spinal anesthesia, if the anesthesiologist is alert for development of bradycardia.
Literatur
1.
Zurück zum Zitat Brown DL. Spinal, epidural and caudal anesthesia. In: Miller RD, editor. Anesthesia. Philadelphia: Churchill-Livingstone; 2000. p. 1492–8. Brown DL. Spinal, epidural and caudal anesthesia. In: Miller RD, editor. Anesthesia. Philadelphia: Churchill-Livingstone; 2000. p. 1492–8.
2.
Zurück zum Zitat Bernard CM. Epidural and spinal anesthesia. In: Barash PG, editor. Clinical anesthesia. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 645–68. Bernard CM. Epidural and spinal anesthesia. In: Barash PG, editor. Clinical anesthesia. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 645–68.
3.
Zurück zum Zitat Rhee K, Kang K, Kim J, Jeon Y. Intravenous clonidine prolongs bupivacaine spinal anesthesia. Acta Anaesthesiol Scand. 2003;47:1001–5.CrossRefPubMed Rhee K, Kang K, Kim J, Jeon Y. Intravenous clonidine prolongs bupivacaine spinal anesthesia. Acta Anaesthesiol Scand. 2003;47:1001–5.CrossRefPubMed
4.
Zurück zum Zitat Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesthesiol Scand. 2006;50:222–7.CrossRefPubMed Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesthesiol Scand. 2006;50:222–7.CrossRefPubMed
5.
Zurück zum Zitat Whiteside JB, Burke D, Wildsmith JAW. Spinal anaesthesia with ropivacaine 5 mg/ml in glucose 10 mg/ml or 50 mg/ml. Br J Anaesth. 2001;86:241–4.CrossRefPubMed Whiteside JB, Burke D, Wildsmith JAW. Spinal anaesthesia with ropivacaine 5 mg/ml in glucose 10 mg/ml or 50 mg/ml. Br J Anaesth. 2001;86:241–4.CrossRefPubMed
6.
Zurück zum Zitat Whiteside JB, Burke D, Wildsmith JAW. Comparison of ropivacaine 0.5% (in glucose 5%) with bupivacaine 0.5% (in glucose 8%) for spinal anaesthesia for elective surgery. Br J Anaesth. 2003;90:304–8.CrossRefPubMed Whiteside JB, Burke D, Wildsmith JAW. Comparison of ropivacaine 0.5% (in glucose 5%) with bupivacaine 0.5% (in glucose 8%) for spinal anaesthesia for elective surgery. Br J Anaesth. 2003;90:304–8.CrossRefPubMed
7.
Zurück zum Zitat McLeod GA. Density of spinal anaesthetic solutions of bupivacaine, levobupivacaine, and ropivacaine with and without dextrose. Br J Anaesth. 2004;92:547–51.CrossRefPubMed McLeod GA. Density of spinal anaesthetic solutions of bupivacaine, levobupivacaine, and ropivacaine with and without dextrose. Br J Anaesth. 2004;92:547–51.CrossRefPubMed
8.
Zurück zum Zitat Chung CJ, Choi SR, Yeo KH, Park HS, Lee SI, Chin YJ. Hyperbaric spinal ropivacaine for cesarean delivery: a comparison to hyperbaric bupivacaine. Anesth Analg. 2001;93:157–61.CrossRefPubMed Chung CJ, Choi SR, Yeo KH, Park HS, Lee SI, Chin YJ. Hyperbaric spinal ropivacaine for cesarean delivery: a comparison to hyperbaric bupivacaine. Anesth Analg. 2001;93:157–61.CrossRefPubMed
9.
Zurück zum Zitat Dawson C, Ma D, Chow A, Maze M. Dexmedetomidine enhances analgesic action of nitrous oxide: mechanisms of action. Anesthesiology. 2004;100:894–904.CrossRefPubMed Dawson C, Ma D, Chow A, Maze M. Dexmedetomidine enhances analgesic action of nitrous oxide: mechanisms of action. Anesthesiology. 2004;100:894–904.CrossRefPubMed
10.
Zurück zum Zitat Gentili M, Huu PC, Enel D, Hollande J, Bonnet F. Sedation depends on the level of sensory block induced by spinal anaesthesia. Br J Anaesth. 1998;81:970–1.PubMed Gentili M, Huu PC, Enel D, Hollande J, Bonnet F. Sedation depends on the level of sensory block induced by spinal anaesthesia. Br J Anaesth. 1998;81:970–1.PubMed
11.
Zurück zum Zitat Pollock JE, Neal JM, Liu SS, Burkhead D, Polissar N. Sedation during spinal anesthesia. Anesthesiology. 2000;93:728–34.CrossRefPubMed Pollock JE, Neal JM, Liu SS, Burkhead D, Polissar N. Sedation during spinal anesthesia. Anesthesiology. 2000;93:728–34.CrossRefPubMed
12.
Zurück zum Zitat Pouttu J, Scheinin B, Rosenberg PH, Viinamaki O, Scheinin M. Oral premedication with clonidine: effects on stress responses during general anaesthesia. Acta Anaesthesiol Scand. 1987;31:730–4.CrossRefPubMed Pouttu J, Scheinin B, Rosenberg PH, Viinamaki O, Scheinin M. Oral premedication with clonidine: effects on stress responses during general anaesthesia. Acta Anaesthesiol Scand. 1987;31:730–4.CrossRefPubMed
13.
Zurück zum Zitat Almeida RA, Lauretti GR, Mattos AL. Antinociceptive effect of low-dose intrathecal neostigmine combined with intrathecal morphine following gynecologic surgery. Anesthesiology. 2003;98:495–8.CrossRefPubMed Almeida RA, Lauretti GR, Mattos AL. Antinociceptive effect of low-dose intrathecal neostigmine combined with intrathecal morphine following gynecologic surgery. Anesthesiology. 2003;98:495–8.CrossRefPubMed
14.
Zurück zum Zitat Maze M, Tranquilli W. Alpha-2 adrenoceptor agonists: defining the role in clinical anesthesia. Anesthesiology. 1991;74:581–605.CrossRefPubMed Maze M, Tranquilli W. Alpha-2 adrenoceptor agonists: defining the role in clinical anesthesia. Anesthesiology. 1991;74:581–605.CrossRefPubMed
15.
Zurück zum Zitat Mikawa K, Nishina K, Maekawa N, Obara H. Oral clonidine premedication reduces postoperative pain in children. Anesth Analg. 1996;82:225–30.CrossRefPubMed Mikawa K, Nishina K, Maekawa N, Obara H. Oral clonidine premedication reduces postoperative pain in children. Anesth Analg. 1996;82:225–30.CrossRefPubMed
16.
Zurück zum Zitat Weinbroum AA, Ben-Abraham R. Dextromethorphan and dexmedetomidine: new agents for the control of perioperative pain. Eur J Surg. 2001;167:563–9.CrossRefPubMed Weinbroum AA, Ben-Abraham R. Dextromethorphan and dexmedetomidine: new agents for the control of perioperative pain. Eur J Surg. 2001;167:563–9.CrossRefPubMed
17.
Zurück zum Zitat Choyce A, Peng P. A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures. Can J Anaesth. 2002;49:32–45.CrossRefPubMed Choyce A, Peng P. A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures. Can J Anaesth. 2002;49:32–45.CrossRefPubMed
18.
Zurück zum Zitat Memis D, Turan A, Karamanlioglu B, Pamukçu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg. 2004;98:835–40.PubMed Memis D, Turan A, Karamanlioglu B, Pamukçu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg. 2004;98:835–40.PubMed
19.
Zurück zum Zitat Jaakola ML. Dexmedetomidine premedication before intravenous regional anesthesia in minor outpatient hand surgery. J Clin Anesth. 1994;6:204–11.CrossRefPubMed Jaakola ML. Dexmedetomidine premedication before intravenous regional anesthesia in minor outpatient hand surgery. J Clin Anesth. 1994;6:204–11.CrossRefPubMed
20.
Zurück zum Zitat Lurie SD, Reuben SS, Gibson CS, DeLuca PA, Maciolek HA. Effect of clonidine on upper extremity tourniquet pain in healthy volunteers. Reg Anesth Pain Med. 2000;25:502–5.PubMed Lurie SD, Reuben SS, Gibson CS, DeLuca PA, Maciolek HA. Effect of clonidine on upper extremity tourniquet pain in healthy volunteers. Reg Anesth Pain Med. 2000;25:502–5.PubMed
21.
Zurück zum Zitat Kristensen JD, Karlsten R, Gordh T. Spinal cord blood flow after intrathecal injection of ropivacaine: a screening for neurotoxic effects. Anesth Analg. 1996;82:636–40.CrossRefPubMed Kristensen JD, Karlsten R, Gordh T. Spinal cord blood flow after intrathecal injection of ropivacaine: a screening for neurotoxic effects. Anesth Analg. 1996;82:636–40.CrossRefPubMed
22.
Zurück zum Zitat Kallio A, Scheinin M, Koulu M, Ponkilainen R, Ruskoaho H, Viinamäki O, Scheinin H. Effects of dexmedetomidine, a selective α-2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin Pharmacol Ther. 1989;46:33–42.PubMed Kallio A, Scheinin M, Koulu M, Ponkilainen R, Ruskoaho H, Viinamäki O, Scheinin H. Effects of dexmedetomidine, a selective α-2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin Pharmacol Ther. 1989;46:33–42.PubMed
23.
Zurück zum Zitat Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology. 1992;77:1134–42.CrossRefPubMed Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology. 1992;77:1134–42.CrossRefPubMed
24.
Zurück zum Zitat Mantz J. Dexmedetomidine. Drugs Today (Barc). 1999;35:151–7. Mantz J. Dexmedetomidine. Drugs Today (Barc). 1999;35:151–7.
25.
Zurück zum Zitat Carpenter RL, Caplan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology. 1992;76:906–16.CrossRefPubMed Carpenter RL, Caplan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology. 1992;76:906–16.CrossRefPubMed
26.
Zurück zum Zitat Katı İ, Demirel CB, Abbasov ÜH, Silay E, Coşkuner İ, Tomak Y. İğne Tipinin Spinal Anestezi Komplikasyonları Üzerine Etkileri. Van Tıp Dergisi. 2002;9:20–4. Katı İ, Demirel CB, Abbasov ÜH, Silay E, Coşkuner İ, Tomak Y. İğne Tipinin Spinal Anestezi Komplikasyonları Üzerine Etkileri. Van Tıp Dergisi. 2002;9:20–4.
27.
Zurück zum Zitat Tarkkila PJ, Heine H, Tervo RR. Comparison of Sprotte and Quincke needles with respect to post dural puncture headache and backache. Reg Anesth. 1992;17:283–7.PubMed Tarkkila PJ, Heine H, Tervo RR. Comparison of Sprotte and Quincke needles with respect to post dural puncture headache and backache. Reg Anesth. 1992;17:283–7.PubMed
28.
Zurück zum Zitat Vassilieff N, Rosencher N, Sessler DI, Conseiller C. Shivering threshold during spinal anesthesia is reduced in elderly patients. Anesthesiology. 1995;83:1162–6.CrossRefPubMed Vassilieff N, Rosencher N, Sessler DI, Conseiller C. Shivering threshold during spinal anesthesia is reduced in elderly patients. Anesthesiology. 1995;83:1162–6.CrossRefPubMed
29.
Zurück zum Zitat Sessler DI. Perianesthetic thermoregulation and heat balance in humans. FASEB J. 1993;7:638–44.PubMed Sessler DI. Perianesthetic thermoregulation and heat balance in humans. FASEB J. 1993;7:638–44.PubMed
Metadaten
Titel
The effects of intravenous dexmedetomidine on spinal hyperbaric ropivacaine anesthesia
verfasst von
Kamuran Elcıcek
Murat Tekın
Ismail Katı
Publikationsdatum
01.08.2010
Verlag
Springer Japan
Erschienen in
Journal of Anesthesia / Ausgabe 4/2010
Print ISSN: 0913-8668
Elektronische ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-010-0939-9

Weitere Artikel der Ausgabe 4/2010

Journal of Anesthesia 4/2010 Zur Ausgabe

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Delir bei kritisch Kranken – Antipsychotika versus Placebo

16.05.2024 Delir Nachrichten

Um die Langzeitfolgen eines Delirs bei kritisch Kranken zu mildern, wird vielerorts auf eine Akuttherapie mit Antipsychotika gesetzt. Eine US-amerikanische Forschungsgruppe äußert jetzt erhebliche Vorbehalte gegen dieses Vorgehen. Denn es gibt neue Daten zum Langzeiteffekt von Haloperidol bzw. Ziprasidon versus Placebo.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.