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Erschienen in: Journal of Anesthesia 1/2017

29.08.2016 | Original Article

The effect of dexmedetomidine pretreatment on the median effective bolus dose of propofol for facilitating laryngeal mask airway insertion

verfasst von: Ji Young Yoo, Hyun Jeong Kwak, Yong Beom Kim, Chu Kyung Park, Sook Young Lee, Jong Yeop Kim

Erschienen in: Journal of Anesthesia | Ausgabe 1/2017

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Abstract

Background

We designed this study to investigate the effect of dexmedetomidine (1 μg/kg) pretreatment on the median effective dose (ED50) of propofol for facilitating successful laryngeal mask airway (LMA) insertion compared to propofol alone.

Methods

Forty patients were randomized to either the control group (n = 21) or the dexmedetomidine group (n = 19). After infusion of normal saline or dexmedetomidine 1 µg/kg over 10 min, 1 % lidocaine 0.5 mg/kg, followed by propofol 2.5 mg/kg was administered and the laryngeal mask airway was inserted without muscle relaxants. The ED50 of propofol for successful LMA insertion was determined by the modified Dixon’s up-and-down method. The ED50 and ED95 were also calculated using an isotonic regression method, based on the pooled adjacent-violators algorithm-adjusted response rate, and the confidential interval (CI) was estimated using a bootstrap approach.

Results

The ED50 of propofol for smooth insertion of the LMA was significantly higher in the control group than in the dexmedetomidine group (3.1 ± 0.4 vs 1.9 ± 0.3 mg/kg, P < 0.001). From isotonic regression analysis using a bootstrap approach, the ED50 and ED95 of propofol was 2.9 mg/kg (83 % CI 2.5–3.3 mg/kg) and 3.9 mg/kg (95 % CI 3.5–4.0 mg/kg) in the control group, and 1.8 mg/kg (83 % CI 1.8–2.1 mg/kg) and 2.4 mg/kg (95 % CI 2.0–2.5 mg/kg) in the dexmedetomidine groups, respectively. The apnea time was not significantly different between the two groups.

Conclusions

Pretreatment with dexmedetomidine 1 μg/kg could reduce the propofol requirement by 38 % for facilitating LMA insertion without prolonged respiratory depression and hemodynamic instability.
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Metadaten
Titel
The effect of dexmedetomidine pretreatment on the median effective bolus dose of propofol for facilitating laryngeal mask airway insertion
verfasst von
Ji Young Yoo
Hyun Jeong Kwak
Yong Beom Kim
Chu Kyung Park
Sook Young Lee
Jong Yeop Kim
Publikationsdatum
29.08.2016
Verlag
Springer Japan
Erschienen in
Journal of Anesthesia / Ausgabe 1/2017
Print ISSN: 0913-8668
Elektronische ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-016-2245-7

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