Display options
Cite
Choi YM, Choi EJ, Ri HS, et al. The effect of dexmedetomidine and midazolam on combined spinal-epidural anesthesia in patients undergoing total knee arthroplasty. Anesth Pain Med (Seoul). 2020;15(1):111-119doi: 10.17085/apm.2020.15.1.111.
Choi, Y. M., Choi, E. J., Ri, H. S., Park, J. Y., You, J. A., & Byeon, G. J. (2020). The effect of dexmedetomidine and midazolam on combined spinal-epidural anesthesia in patients undergoing total knee arthroplasty. Anesthesia and pain medicine, 15(1), 111-119. https://doi.org/10.17085/apm.2020.15.1.111
Choi, Yun-Mi, et al. "The effect of dexmedetomidine and midazolam on combined spinal-epidural anesthesia in patients undergoing total knee arthroplasty." Anesthesia and pain medicine vol. 15,1 (2020): 111-119. doi: https://doi.org/10.17085/apm.2020.15.1.111
Choi YM, Choi EJ, Ri HS, Park JY, You JA, Byeon GJ. The effect of dexmedetomidine and midazolam on combined spinal-epidural anesthesia in patients undergoing total knee arthroplasty. Anesth Pain Med (Seoul). 2020 Jan 31;15(1):111-119. doi: 10.17085/apm.2020.15.1.111. PMID: 33329799; PMCID: PMC7713863.
Copy Download .nbib Format: NLM
Share it on

Anesth Pain Med (Seoul). 2020 Jan 31;15(1):111-119. doi: 10.17085/apm.2020.15.1.111.

The effect of dexmedetomidine and midazolam on combined spinal-epidural anesthesia in patients undergoing total knee arthroplasty.

Anesthesia and pain medicine

Yun-Mi Choi, Eun-Ji Choi, Hyun-Su Ri, Ju Yeon Park, Jun-A You, Gyeong-Jo Byeon

Affiliations

  1. Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
  2. Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

PMID: 33329799 PMCID: PMC7713863 DOI: 10.17085/apm.2020.15.1.111

Abstract

BACKGROUND: Intravenous dexmedetomidine has been reported to potentiate the anesthetic effect of local anesthetics and improve the quality of postoperative analgesia when used as an adjuvant in neuraxial block. We compared the effects of intravenous dexmedetomidine and midazolam for sedation on combined spinal-epidural (CSE) anesthesia.

METHODS: This study included 50 patients undergoing total knee arthroplasty. CSE anesthesia was given using 10 mg bupivacaine for all patients. After checking the maximum sensory and motor levels, the patients were randomly allocated into two groups of 25 each to receive intravenous continuous infusion of dexmedetomidine (Group D) or midazolam (Group M) for sedation during surgery. Regression block level, hemodynamic changes, and sedation score were compared between the groups when the patients entered the postanesthetic care unit (PACU). For patient-controlled epidural analgesia, 0.2% levobupivacaine with 650 µg of fentanyl (150 ml in total) was infused at a rate of 1 ml/h, in addition to a 3-ml bolus dose with a 30-min lockout time. The visual analogue scale scores, additional analgesic demand, patient satisfaction, and adverse events between the two groups were also compared postoperatively.

RESULTS: A significant difference was observed in relation to the sensory block level in the PACU (Group D: 6.3 ± 2.1; Group M: 3.2 ± 1.9) (P = 0.002). The motor block level and other outcomes showed no significant intergroup differences.

CONCLUSIONS: Intravenous injection of dexmedetomidine, rather than midazolam, for procedural sedation is associated with prolonged sensory block, with comparable incidences of adverse events during CSE anesthesia.

Copyright © the Korean Society of Anesthesiologists, 2020.

Keywords: Dexmedetomidine; Epidural analgesia; Knee arthropalsty; Midazolam; Sedation; Spinal anesthesia

Conflict of interest statement

CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported.

References

  1. Clin Drug Investig. 2017 Apr;37(4):343-354 - PubMed
  2. J Anesth. 2010 Aug;24(4):544-8 - PubMed
  3. Br J Anaesth. 2016 Feb;116(2):163-76 - PubMed
  4. Br J Anaesth. 2008 Jan;100(1):8-16 - PubMed
  5. Reg Anesth. 1997 Sep-Oct;22(5):406-23 - PubMed
  6. Anesth Analg. 2002 Aug;95(2):461-6, table of contents - PubMed
  7. Middle East J Anaesthesiol. 2009 Jun;20(2):225-31 - PubMed
  8. F1000 Med Rep. 2010 Dec 17;2:90 - PubMed
  9. Eur J Pharmacol. 1988 May 20;150(1-2):9-14 - PubMed
  10. Korean J Pain. 2014 Oct;27(4):313-20 - PubMed
  11. Reg Anesth Pain Med. 2017 Mar/Apr;42(2):184-196 - PubMed
  12. Br Med J. 1974 Jun 22;2(5920):656-9 - PubMed
  13. Med Care. 1988 Apr;26(4):393-402 - PubMed
  14. Anesth Analg. 2013 Jul;117(1):271-8 - PubMed
  15. Br J Anaesth. 1993 Sep;71(3):447-9 - PubMed
  16. Anesthesiology. 2004 Nov;101(5):1077-83 - PubMed
  17. Anesth Essays Res. 2018 Apr-Jun;12(2):539-545 - PubMed
  18. Acta Anaesthesiol Scand. 2012 Mar;56(3):382-7 - PubMed
  19. Saudi J Anaesth. 2014 Apr;8(2):202-8 - PubMed
  20. Can J Anaesth. 2010 Jan;57(1):39-45 - PubMed
  21. Anesthesiology. 2004 Apr;100(4):894-904 - PubMed
  22. Br J Anaesth. 2006 Jun;96(6):722-6 - PubMed
  23. Anaesthesia. 1984 Jun;39(6):589-93 - PubMed
  24. Korean J Pain. 2016 Jan;29(1):29-33 - PubMed
  25. Acta Anaesthesiol Scand. 2003 Sep;47(8):1001-5 - PubMed
  26. Drug Dev Ind Pharm. 2016 Dec;42(12):1917-1927 - PubMed

Publication Types