Anesth Pain Med.  2019 Jan;14(1):29-34. 10.17085/apm.2019.14.1.29.

Effects of preanesthetic single administration of dexmedetomidine on the remifentanil and propofol requirement during laparoscopic cholecystectomy

• Park H
• Kim HS
• Kim JW
• Lee GG
• Park DH
• Jeong CY
• Park SG
• Ryu KH

• KMID: 2434195
• DOI: http://doi.org/10.17085/apm.2019.14.1.29

Abstract

BACKGROUND
Dexmedetomidine, an α2-adrenergic agonist, can be used for sedation and as an adjuvant to anesthetics. This study aimed to evaluate the effects of preanesthetic administration of dexmedetomidine on the propofol and remifentanil requirement during general anesthesia and postoperative pain in patients undergoing laparoscopic cholecystectomy.
METHODS
Sixty patients were randomly assigned to group D or S (n = 30 each). Dexmedetomidine (0.5 µg/kg) and a comparable volume of saline were administered in groups D and S, respectively, over a 10 minutes period before induction. General anesthesia was induced and maintained with propofol and remifentanil; the bispectral index was maintained at 40-60. The intraoperative remifentanil and propofol dosages were recorded, and postoperative pain was assessed using a visual analog scale (VAS).
RESULTS
In groups S and D, propofol dosage was 8.52 ± 1.64 and 6.83 ± 1.55 mg/kg/h, respectively (P < 0.001), while remifentanil dosage was 7.18 ± 2.42 and 4.84 ± 1.44 µg/ kg/h, respectively (P < 0.001). VAS scores for postoperative pain were 6.50 (6-7) and 6.0 (6-7), respectively, at 30 minutes (P = 0.569), 5 (4-5) and 4 (3-5), respectively, at 12 hours (P = 0.039), and 2 (2-3) and 2 (1.25-2), respectively, at 24 hours (P = 0.044). The Friedman test revealed that VAS scores changed over time in both groups (P < 0.001).
CONCLUSIONS
Preanesthetic single administration of a low dose of dexmedetomidine (0.5 µg/kg) can significantly decrease the remifentanil and propofol requirement during short surgeries and alleviate postoperative pain.

Keyword

Anesthetics; Dexmedetomidine; Laparoscopic cholecystectomy; Propofol; Remifentanil

MeSH Terms

Anesthesia, General
Anesthetics
Cholecystectomy, Laparoscopic*
Dexmedetomidine*
Humans
Pain, Postoperative
Propofol*
Visual Analog Scale
Anesthetics
Dexmedetomidine
Propofol

Figure

• 

  Fig. 1 Standardized dosages of propofol (A) and remifentanil (B) for patients who underwent laparoscopic cholecystectomy with or without preanesthetic administration of a single lading dose of dexmedetomidine. Group S: saline group, Group D: dexmedetomidine group. *P < 0.05 determined using Student’s t-test.

• 

  Fig. 2 Changes in postoperative pain over time in patients who underwent laparoscopic cholecystectomy with or without preanesthetic administration of a single loading dose of dexmedetomidine. Group S: saline group, Group D: dexmedetomidine group, VAS: visual analog scale, Postop: postoperative. *P < 0.05 determined using the Friedman test and a post hoc Wilcoxon signed-rank test with Bonferroni correction.

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