Dexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass
Purpose We previously confirmed the effectiveness of dexmedetomidine (DEX) for stabilizing hemodynamics as well as sparing anesthetics during anesthetic induction in patients undergoing cardiac surgery (Kunisawa et al. in J Clin Anesth 21:194–199, 1 ). In this study, we investigated whether these ef...
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| Veröffentlicht in: | Journal of anesthesia 2011-12, Vol.25 (6), p.818-822 |
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| creator | Kunisawa, Takayuki Ueno, Megumi Kurosawa, Atsushi Nagashima, Michio Hayashi, Dai Sasakawa, Tomoki Suzuki, Akihiro Takahata, Osamu Iwasaki, Hiroshi |
| description | Purpose
We previously confirmed the effectiveness of dexmedetomidine (DEX) for stabilizing hemodynamics as well as sparing anesthetics during anesthetic induction in patients undergoing cardiac surgery (Kunisawa et al. in J Clin Anesth 21:194–199,
1
). In this study, we investigated whether these effects of DEX continue until the start of cardiopulmonary bypass (CPB).
Methods
Twenty-two patients with mild to moderate cardiovascular disease were randomized into two groups [DF2 group: DEX dose of 0.7 μg/kg/h after initial dose and effect-site concentration (ESC) of fentanyl of 2 ng/ml; PF4 group: saline and ESC of fentanyl of 4 ng/ml]. Propofol was administered for anesthetic induction and maintenance. Hemodynamics, cardiovascular drugs, ESC of propofol, and cardiovascular responses to skin incision (SI) and sternotomy (St) were measured or calculated.
Results
Blood pressure (BP) at the pre-/post-SI periods was higher in the DEX group (137 ± 17/140 ± 16 mmHg) than in the placebo group (85 ± 9/109 ± 24 mmHg). Percent increases in cardiovascular response to SI or St were lower in the DEX group than in the placebo group (for example, 1.9 ± 2.2 vs. 27.4 ± 19.9% in systolic BP due to SI). ESCs of propofol at SI and St in the DEX group were lower than those in the placebo group.
Conclusions
DEX combined with 2 ng/ml fentanyl before CPB can suppress the decrease in blood pressure at the pre- and post-SI periods, can blunt the cardiovascular responses to SI and St, and can spare the required ESC of propofol despite fentanyl concentration, which was half of that in the placebo group. |
| doi_str_mv | 10.1007/s00540-011-1215-3 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_911942583</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A356808710</galeid><sourcerecordid>A356808710</sourcerecordid><originalsourceid>FETCH-LOGICAL-c501t-386ecec9698cb54948fd87e755f79ddc409064a163b9709f543f4cb3d8ae9e383</originalsourceid><addsrcrecordid>eNp9kU-LFDEQxYMo7rj6AbxIgwdPvVZNOt3JcVn_woIXvRrSSfVslu5kTLrB8dObpldBGCSHhMrvFVXvMfYS4QoBurcZQDRQA2KNexQ1f8R22HBZSy7UY7YDhbyWbSsv2LOc7wGgReRP2cUeFSDnsGPf39HPiRzNcfLOB6qsCVWeTe9H_4uqO5qiOwUzeZsrE1yVjyZReVGe72heqz0NMa265Hw8LuMUg0mnqj8dTc7P2ZPBjJlePNyX7NuH919vPtW3Xz5-vrm-ra0AnGsuW7JkVauk7UWjGjk42VEnxNAp52wDCtrGYMt71YEaRMOHxvbcSUOKuOSX7M3W95jij6UMpyefLY1jmTQuWStE1eyF5IV8vZEHM5L2YYhzMnal9TUXrQTZIRSqPkMdKFAyYww0-FL-h786w5fjqFh3VoCbwKaYc6JBH5OfinEaQa_h6i1cXcLVa7h6Hf3Vw5JLXzL7q_iTZgH2G5DLVzhQ0vdxSaEY_5-uvwGW-q6s</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>911942583</pqid></control><display><type>article</type><title>Dexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kunisawa, Takayuki ; Ueno, Megumi ; Kurosawa, Atsushi ; Nagashima, Michio ; Hayashi, Dai ; Sasakawa, Tomoki ; Suzuki, Akihiro ; Takahata, Osamu ; Iwasaki, Hiroshi</creator><creatorcontrib>Kunisawa, Takayuki ; Ueno, Megumi ; Kurosawa, Atsushi ; Nagashima, Michio ; Hayashi, Dai ; Sasakawa, Tomoki ; Suzuki, Akihiro ; Takahata, Osamu ; Iwasaki, Hiroshi</creatorcontrib><description>Purpose
We previously confirmed the effectiveness of dexmedetomidine (DEX) for stabilizing hemodynamics as well as sparing anesthetics during anesthetic induction in patients undergoing cardiac surgery (Kunisawa et al. in J Clin Anesth 21:194–199,
1
). In this study, we investigated whether these effects of DEX continue until the start of cardiopulmonary bypass (CPB).
Methods
Twenty-two patients with mild to moderate cardiovascular disease were randomized into two groups [DF2 group: DEX dose of 0.7 μg/kg/h after initial dose and effect-site concentration (ESC) of fentanyl of 2 ng/ml; PF4 group: saline and ESC of fentanyl of 4 ng/ml]. Propofol was administered for anesthetic induction and maintenance. Hemodynamics, cardiovascular drugs, ESC of propofol, and cardiovascular responses to skin incision (SI) and sternotomy (St) were measured or calculated.
Results
Blood pressure (BP) at the pre-/post-SI periods was higher in the DEX group (137 ± 17/140 ± 16 mmHg) than in the placebo group (85 ± 9/109 ± 24 mmHg). Percent increases in cardiovascular response to SI or St were lower in the DEX group than in the placebo group (for example, 1.9 ± 2.2 vs. 27.4 ± 19.9% in systolic BP due to SI). ESCs of propofol at SI and St in the DEX group were lower than those in the placebo group.
Conclusions
DEX combined with 2 ng/ml fentanyl before CPB can suppress the decrease in blood pressure at the pre- and post-SI periods, can blunt the cardiovascular responses to SI and St, and can spare the required ESC of propofol despite fentanyl concentration, which was half of that in the placebo group.</description><identifier>ISSN: 0913-8668</identifier><identifier>EISSN: 1438-8359</identifier><identifier>DOI: 10.1007/s00540-011-1215-3</identifier><identifier>PMID: 21901330</identifier><language>eng</language><publisher>Japan: Springer Japan</publisher><subject><![CDATA[Aged ; Analgesics, Non-Narcotic - administration & dosage ; Anesthesiology ; Anesthetics, Intravenous - administration & dosage ; Blood Pressure - drug effects ; Cardiac patients ; Cardiopulmonary Bypass - methods ; Cardiovascular diseases ; Coronary artery bypass ; Critical Care Medicine ; Dexmedetomidine - administration & dosage ; Emergency Medicine ; Female ; Fentanyl - administration & dosage ; Hemodynamics - drug effects ; Humans ; Intensive ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Pain Medicine ; Propofol ; Propofol - administration & dosage ; Sternotomy - methods]]></subject><ispartof>Journal of anesthesia, 2011-12, Vol.25 (6), p.818-822</ispartof><rights>Japanese Society of Anesthesiologists 2011</rights><rights>COPYRIGHT 2011 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c501t-386ecec9698cb54948fd87e755f79ddc409064a163b9709f543f4cb3d8ae9e383</citedby><cites>FETCH-LOGICAL-c501t-386ecec9698cb54948fd87e755f79ddc409064a163b9709f543f4cb3d8ae9e383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00540-011-1215-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00540-011-1215-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21901330$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kunisawa, Takayuki</creatorcontrib><creatorcontrib>Ueno, Megumi</creatorcontrib><creatorcontrib>Kurosawa, Atsushi</creatorcontrib><creatorcontrib>Nagashima, Michio</creatorcontrib><creatorcontrib>Hayashi, Dai</creatorcontrib><creatorcontrib>Sasakawa, Tomoki</creatorcontrib><creatorcontrib>Suzuki, Akihiro</creatorcontrib><creatorcontrib>Takahata, Osamu</creatorcontrib><creatorcontrib>Iwasaki, Hiroshi</creatorcontrib><title>Dexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass</title><title>Journal of anesthesia</title><addtitle>J Anesth</addtitle><addtitle>J Anesth</addtitle><description>Purpose
We previously confirmed the effectiveness of dexmedetomidine (DEX) for stabilizing hemodynamics as well as sparing anesthetics during anesthetic induction in patients undergoing cardiac surgery (Kunisawa et al. in J Clin Anesth 21:194–199,
1
). In this study, we investigated whether these effects of DEX continue until the start of cardiopulmonary bypass (CPB).
Methods
Twenty-two patients with mild to moderate cardiovascular disease were randomized into two groups [DF2 group: DEX dose of 0.7 μg/kg/h after initial dose and effect-site concentration (ESC) of fentanyl of 2 ng/ml; PF4 group: saline and ESC of fentanyl of 4 ng/ml]. Propofol was administered for anesthetic induction and maintenance. Hemodynamics, cardiovascular drugs, ESC of propofol, and cardiovascular responses to skin incision (SI) and sternotomy (St) were measured or calculated.
Results
Blood pressure (BP) at the pre-/post-SI periods was higher in the DEX group (137 ± 17/140 ± 16 mmHg) than in the placebo group (85 ± 9/109 ± 24 mmHg). Percent increases in cardiovascular response to SI or St were lower in the DEX group than in the placebo group (for example, 1.9 ± 2.2 vs. 27.4 ± 19.9% in systolic BP due to SI). ESCs of propofol at SI and St in the DEX group were lower than those in the placebo group.
Conclusions
DEX combined with 2 ng/ml fentanyl before CPB can suppress the decrease in blood pressure at the pre- and post-SI periods, can blunt the cardiovascular responses to SI and St, and can spare the required ESC of propofol despite fentanyl concentration, which was half of that in the placebo group.</description><subject>Aged</subject><subject>Analgesics, Non-Narcotic - administration & dosage</subject><subject>Anesthesiology</subject><subject>Anesthetics, Intravenous - administration & dosage</subject><subject>Blood Pressure - drug effects</subject><subject>Cardiac patients</subject><subject>Cardiopulmonary Bypass - methods</subject><subject>Cardiovascular diseases</subject><subject>Coronary artery bypass</subject><subject>Critical Care Medicine</subject><subject>Dexmedetomidine - administration & dosage</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Fentanyl - administration & dosage</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Intensive</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Propofol</subject><subject>Propofol - administration & dosage</subject><subject>Sternotomy - methods</subject><issn>0913-8668</issn><issn>1438-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-LFDEQxYMo7rj6AbxIgwdPvVZNOt3JcVn_woIXvRrSSfVslu5kTLrB8dObpldBGCSHhMrvFVXvMfYS4QoBurcZQDRQA2KNexQ1f8R22HBZSy7UY7YDhbyWbSsv2LOc7wGgReRP2cUeFSDnsGPf39HPiRzNcfLOB6qsCVWeTe9H_4uqO5qiOwUzeZsrE1yVjyZReVGe72heqz0NMa265Hw8LuMUg0mnqj8dTc7P2ZPBjJlePNyX7NuH919vPtW3Xz5-vrm-ra0AnGsuW7JkVauk7UWjGjk42VEnxNAp52wDCtrGYMt71YEaRMOHxvbcSUOKuOSX7M3W95jij6UMpyefLY1jmTQuWStE1eyF5IV8vZEHM5L2YYhzMnal9TUXrQTZIRSqPkMdKFAyYww0-FL-h786w5fjqFh3VoCbwKaYc6JBH5OfinEaQa_h6i1cXcLVa7h6Hf3Vw5JLXzL7q_iTZgH2G5DLVzhQ0vdxSaEY_5-uvwGW-q6s</recordid><startdate>20111201</startdate><enddate>20111201</enddate><creator>Kunisawa, Takayuki</creator><creator>Ueno, Megumi</creator><creator>Kurosawa, Atsushi</creator><creator>Nagashima, Michio</creator><creator>Hayashi, Dai</creator><creator>Sasakawa, Tomoki</creator><creator>Suzuki, Akihiro</creator><creator>Takahata, Osamu</creator><creator>Iwasaki, Hiroshi</creator><general>Springer Japan</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20111201</creationdate><title>Dexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass</title><author>Kunisawa, Takayuki ; Ueno, Megumi ; Kurosawa, Atsushi ; Nagashima, Michio ; Hayashi, Dai ; Sasakawa, Tomoki ; Suzuki, Akihiro ; Takahata, Osamu ; Iwasaki, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c501t-386ecec9698cb54948fd87e755f79ddc409064a163b9709f543f4cb3d8ae9e383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Analgesics, Non-Narcotic - administration & dosage</topic><topic>Anesthesiology</topic><topic>Anesthetics, Intravenous - administration & dosage</topic><topic>Blood Pressure - drug effects</topic><topic>Cardiac patients</topic><topic>Cardiopulmonary Bypass - methods</topic><topic>Cardiovascular diseases</topic><topic>Coronary artery bypass</topic><topic>Critical Care Medicine</topic><topic>Dexmedetomidine - administration & dosage</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Fentanyl - administration & dosage</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Intensive</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Propofol</topic><topic>Propofol - administration & dosage</topic><topic>Sternotomy - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kunisawa, Takayuki</creatorcontrib><creatorcontrib>Ueno, Megumi</creatorcontrib><creatorcontrib>Kurosawa, Atsushi</creatorcontrib><creatorcontrib>Nagashima, Michio</creatorcontrib><creatorcontrib>Hayashi, Dai</creatorcontrib><creatorcontrib>Sasakawa, Tomoki</creatorcontrib><creatorcontrib>Suzuki, Akihiro</creatorcontrib><creatorcontrib>Takahata, Osamu</creatorcontrib><creatorcontrib>Iwasaki, Hiroshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kunisawa, Takayuki</au><au>Ueno, Megumi</au><au>Kurosawa, Atsushi</au><au>Nagashima, Michio</au><au>Hayashi, Dai</au><au>Sasakawa, Tomoki</au><au>Suzuki, Akihiro</au><au>Takahata, Osamu</au><au>Iwasaki, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass</atitle><jtitle>Journal of anesthesia</jtitle><stitle>J Anesth</stitle><addtitle>J Anesth</addtitle><date>2011-12-01</date><risdate>2011</risdate><volume>25</volume><issue>6</issue><spage>818</spage><epage>822</epage><pages>818-822</pages><issn>0913-8668</issn><eissn>1438-8359</eissn><abstract>Purpose
We previously confirmed the effectiveness of dexmedetomidine (DEX) for stabilizing hemodynamics as well as sparing anesthetics during anesthetic induction in patients undergoing cardiac surgery (Kunisawa et al. in J Clin Anesth 21:194–199,
1
). In this study, we investigated whether these effects of DEX continue until the start of cardiopulmonary bypass (CPB).
Methods
Twenty-two patients with mild to moderate cardiovascular disease were randomized into two groups [DF2 group: DEX dose of 0.7 μg/kg/h after initial dose and effect-site concentration (ESC) of fentanyl of 2 ng/ml; PF4 group: saline and ESC of fentanyl of 4 ng/ml]. Propofol was administered for anesthetic induction and maintenance. Hemodynamics, cardiovascular drugs, ESC of propofol, and cardiovascular responses to skin incision (SI) and sternotomy (St) were measured or calculated.
Results
Blood pressure (BP) at the pre-/post-SI periods was higher in the DEX group (137 ± 17/140 ± 16 mmHg) than in the placebo group (85 ± 9/109 ± 24 mmHg). Percent increases in cardiovascular response to SI or St were lower in the DEX group than in the placebo group (for example, 1.9 ± 2.2 vs. 27.4 ± 19.9% in systolic BP due to SI). ESCs of propofol at SI and St in the DEX group were lower than those in the placebo group.
Conclusions
DEX combined with 2 ng/ml fentanyl before CPB can suppress the decrease in blood pressure at the pre- and post-SI periods, can blunt the cardiovascular responses to SI and St, and can spare the required ESC of propofol despite fentanyl concentration, which was half of that in the placebo group.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>21901330</pmid><doi>10.1007/s00540-011-1215-3</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Analgesics, Non-Narcotic - administration & dosage Anesthesiology Anesthetics, Intravenous - administration & dosage Blood Pressure - drug effects Cardiac patients Cardiopulmonary Bypass - methods Cardiovascular diseases Coronary artery bypass Critical Care Medicine Dexmedetomidine - administration & dosage Emergency Medicine Female Fentanyl - administration & dosage Hemodynamics - drug effects Humans Intensive Male Medicine Medicine & Public Health Middle Aged Original Article Pain Medicine Propofol Propofol - administration & dosage Sternotomy - methods |
| title | Dexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass |
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