دورية أكاديمية
Determining the Optimal Dosage of Dexmedetomidine for Smooth Emergence in Older Patients Undergoing Spinal Surgery: A Study of 44 Cases.
| العنوان: | Determining the Optimal Dosage of Dexmedetomidine for Smooth Emergence in Older Patients Undergoing Spinal Surgery: A Study of 44 Cases. |
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| المؤلفون: | Ahn H; Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea., Chae YJ; Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea., Choi GB; Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea., Lee MG; Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea., Yoo JY; Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea. |
| المصدر: | Medical science monitor : international medical journal of experimental and clinical research [Med Sci Monit] 2024 Jun 09; Vol. 30, pp. e944427. Date of Electronic Publication: 2024 Jun 09. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: International Scientific Information, Inc Country of Publication: United States NLM ID: 9609063 Publication Model: Electronic Cited Medium: Internet ISSN: 1643-3750 (Electronic) Linking ISSN: 12341010 NLM ISO Abbreviation: Med Sci Monit Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2014- : Smithtown, NY : International Scientific Information, Inc. Original Publication: Warsaw, Poland : Medical Science International |
| مواضيع طبية MeSH: | Dexmedetomidine*/administration & dosage , Dexmedetomidine*/pharmacology , Hypnotics and Sedatives*/administration & dosage , Anesthesia Recovery Period*, Humans ; Aged ; Male ; Female ; Anesthesia, General/methods ; Spine/surgery ; Aged, 80 and over ; Dose-Response Relationship, Drug ; Emergence Delirium/prevention & control |
| مستخلص: | BACKGROUND Emergence agitation, or delirium, occurs during early recovery from general anesthesia and involves disorientation, excitation, and uncontrolled physical movements. Dexmedetomidine is an alpha agonist that has sedative, anxiolytic, analgesic, and sympatholytic activities and is used as a continuous infusion to prevent emergence agitation. This study aimed to evaluate patients aged 65 years and older undergoing general anesthesia to determine the 90% effective dose (ED90) of dexmedetomidine continuous intraoperative infusion to prevent emergence agitation. MATERIAL AND METHODS We enrolled 44 patients aged 65 years and older undergoing spinal surgery under general anesthesia. Dexmedetomidine administration commenced 30 minutes before surgery completion, with a predetermined infusion dose (μg/kg/h), without a loading dose. The initial dose was 0.2 μg/kg/h, and subsequent step size was ±0.05 μg/kg/h. We tried to find ED90 of dexmedetomidine using the biased-coin design. Vital signs, extubation quality scores, extubation-related complications, and postoperative outcomes were monitored. RESULTS Dexmedetomidine ED₉₀ for smooth emergence in older patients was 0.34 μg/kg/h. Peri-extubation vital signs remained within 20% of baseline values, without requiring pharmacological intervention. No hypoxia, hypoventilation, or post-extubation agitation occurred. In the recovery room, 1 patient briefly exhibited excitement but quickly calmed. Nine patients initially unresponsive in the recovery room fully awoke and were promptly discharged. CONCLUSIONS For older patients who are vulnerable to adverse effects of anesthetics and opioids, dexmedetomidine enables gentle awakening without adverse vital sign changes, respiratory depression, excessive sedation, or emergence agitation (ED₉₀=0.34 μg/kg/h). Further studies should involve a larger patient cohort, considering diverse medical conditions in older individuals. |
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| المشرفين على المادة: | 67VB76HONO (Dexmedetomidine) 0 (Hypnotics and Sedatives) |
| تواريخ الأحداث: | Date Created: 20240609 Date Completed: 20240609 Latest Revision: 20240615 |
| رمز التحديث: | 20240615 |
| مُعرف محوري في PubMed: | PMC11171429 |
| DOI: | 10.12659/MSM.944427 |
| PMID: | 38851875 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1643-3750 |
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| DOI: | 10.12659/MSM.944427 |