Journals / Dicle Tıp Dergisi / 2011 / Cilt: 38 - Sayı: 2

Comparison of the sedative effects of midazolam and dexmedetomidine during regional anaesthesia

Rejyonel anestezi sırasında midazolam ve deksmedetomidin’in sedatif etkilerinin karşılaştırılması

Pages
148–154
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Key words: Regional anesthesia, midazolam, dexmedetomidine, sedation.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: The aim of this study was to compare the efficacy of dexmedetomidine versus midazolam for sedation under spinal anesthesia for arthroscopic knee surgery.
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Key Findings & Data:Materials and methods: Fifty adult patients, 18 to 65 years, were randomized into two groups: Group M received 0.04 mg/kg iv bolus midazolam followed by administration of 0.5 mg boluses to provide Ramsay sedation Scale (RSS) 3-4.
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Conclusion & Impact:Key words: Regional anesthesia, midazolam, dexmedetomidine, sedation.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: The aim of this study was to compare the efficacy of dexmedetomidine versus midazolam for sedation under spinal anesthesia for arthroscopic knee surgery. Materials and methods: Fifty adult patients, 18 to 65 years, were randomized into two groups: Group M received 0.04 mg/kg iv bolus midazolam followed by administration of 0.5 mg boluses to provide Ramsay sedation Scale (RSS) 3-4. Group D received dexmedetomidine loading dose of 1 &#956;g/kg/h over 10 minutes and the maintenance dose of 0.2-0.7 &#956;g/kg/h to achieve an adequate level of RSS 3-4. Recovery was evaluated with Modified Aldrete Scale. Pain was scored using Verbal rating scale (VRS). Postoperative VRS and Quality of Recovery (QoR) were recorded. Patients were asked to fill the questionnaire that included 4 questions, and patient satisfaction was rated with VRS. Results: Heart rate and mean blood pressure values were found to be decreased in group D when compared with Group M (p<0.05). Pain scores and patients&#8217; satisfaction VRS values and QoR scores were not different between groups (p>0.05). Conclusion: The present study showed that dexmedetomidine provided similar parameters of recovery and patient satisfaction equivalent to midazolam without negative effects on hemodynamic and respiratory functions. Key words: Regional anesthesia, midazolam, dexmedetomidine, sedation.

Özet

Amaç: Bu çalışmada, spinal anestezi altında artroskopik diz cerrahisi uygulanacak olgulara sedasyon amacıyla deksmedetomidin ve midazolam uygulamasının etkilerini karsılaştırmayı amaçladık. Gereç ve yöntem: Yaşları 18-65 yıl arasında değişen 50 olgu randomizasyon ile iki gruba ayrıldı: Grup M’deki olgulara midazolam 0.04 mg/kg intravenöz (iv) uygulandıktan sonra Ramsay sedasyon skoru (RSS) 3-4 olacak şekilde 0,5 mg ek dozlarla işleme devam edildi. Grup D’deki olgulara deksmedetomidin 1 μg kg/sa olacak şekilde 10 dakika yükleme dozu uygulandı. Takiben olguların RSS 3-4 olacak şekilde 0,2-0,7 μg/kg/sa deksmedetomidin infüzyonuna başlandı. Operasyon süresince olguların vital bulguları kaydedildi. Olguların derlenmeleri modifiye Aldrete skoru (MAS) ile belirlendi. Ağrı değerlendirmesinde sözel nümerik skala (VRS) kullanıldı. Postoperatif VRS ve derlenme kalite skorları (QoR) kaydedildi. Olgulardan 4 sorudan oluşan geri bildirim anketini doldurmaları istendi. Olgu memnuniyeti VRS ile değerlendirildi. Bulgular: Grup D’de kalp hızları Grup M’ye göre düşük bulundu (p 0.05). Postoperatif 8. saatte olguların memnuniyet VRS değerleri ve QoR skorları farklı değildi (p>0.05). Sonuç: Bu çalışmada, uyguladığımız deksmedetomidin ile hemodinamik ve solunumsal parametreler üzerine olumsuz bir etki olmadan, midazolama eşdeğer kalitede derlenme kriterleri ve olgu memnuniyeti sağlayarak sedasyon uygulaması yapılabileceği gösterilmiştir.

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Cite This Article

KORKMAZ, M., GURBET, A., ŞAHİN, Ş., PÜRCÜ, Ö. Ö. (2011). Comparison of the sedative effects of midazolam and dexmedetomidine during regional anaesthesia. Dicle Tıp Dergisi, Cilt: 38 - Sayı: 2, 148–154. https://ajindex.com/articles/349244

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References (20)

  1. Warner MA, Shields SE, Chute CG. Major morbidity and mortality within 1 month of ambulatory surgery and anesthesia. JAMA 1993; 270(12): 1437-41
  2. De Andres J, Valia JC, Gil A, Bolinches R. Predictors of patient satisfaction with regional anaesthesia. Reg Anesth 1995; 20(5): 498-505
  3. Wu CL, Naqibuddin M, Fleisher LA. Measurement of patient satisfaction as an outcome of regional anesthesia and analgesia: a systematic review. Reg Anesth Pain Med 2001; 26: 196-208
  4. Höhener D, Blumenthal S, Borgeat A. Sedation and regional anaesthesia in the adult patient. BJA 2008; 100(1): 8-16
  5. Wilson KE, Girdler NM, Welbury RR. Randomized, controlled, cross-over clinical trial comparing intravenous midazolam sedation with nitrous oxide sedation in children undergoing dental extractions. BJA 2003; 91(8): 850-6
  6. Arain SR, Ebert TJ. The efficacy, side effects, and recovery characteristics of dexmedetomidine versus propofol when used for intraoperative sedation. Anesth Analg 2002; 95(4): 461-6
  7. Bhana N, Goa KL, McClellan KJ. Dexmedetomidine. Drugs 2000; 59(3): 263-8
  8. Ramsay MAE, Savege TM, Simpson BRJ, Goodwin R. Controlled sedation with alphaxolone. British Med J 1974; 12(7): 656-9
  9. P. Hu, D. Harmon, H. Frizelle. Patient comfort during regional anesthesia. J Clin Anesth 2007; 19(1): 67-74
  10. Standl T, Burmeister MA. Fast-track regional anesthesia. Curr Opin Anaesthesiol 2000; 13(6): 643-9
  11. Dahl V, Raeder J. Regional anaesthesia in ambulatory surgery. Curr Opin Anaesthesiol 2003; 16(5): 471-6
  12. Esener Z. Lokal/Bölgesel Anestezi Yöntemleri: Klinik Anestezi
  13. Baskı. Logos Yayıncılık, İstanbul 2004; 552-88
  14. Macario A, Weinger M, Carney S, Kim A. Which clinical anaesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg 1999; 89(7): 652-8
  15. Ashish Sinha. Patient comfort during regional anesthesia: the obvious and the obscure. J Clin Anesth 2007; 19(1): 1-2
  16. Arıboğan A, Ünlügenç H, Reyhan E. Lokal anestezi sırasında “Bilinçli Sedasyon” uygulaması. TARDD 1999; 2(6): 537-44
  17. Olkkola KT, Ahonen J. Midazolam and other benzodiazepines. Handb Exp Pharmacol 2008;2(4): 335-60
  18. Aantaa RE, Kanto JH, Scheinin M, Kallio AM, Scheinin H. Dexmedetomidine premedication for minor gynecologic surgery. Anesth Analg 1990; 70(4): 407-13
  19. Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine: a review of clinical applications. Cur Op Anesth 2008; 21(5): 457-61
  20. Venn RM, Karol MD, Grounds RM. Pharmacokinetics of De