TY - JOUR
T1 - Dexmedetomidine attenuates tourniquet-induced hyperdynamic response in patients undergoing lower limb surgeries
T2 - A randomized controlled study
AU - Lao, Hsuan Chih
AU - Tsai, Pei Shan
AU - Su, Jung Yuan
AU - Kwok, Tiew Guan
AU - Huang, Chun Jen
N1 - Funding Information:
The authors thank Dr. Mei-Chi Lin and Ms. Huy-Fang Wang for technical support. They also thank Mr. Yen-Chun Fan for statistical support. This work was mainly conducted at Mackay Memorial Hospital and was supported by grants from the Mackay Memorial Hospital (MMH 9729) and the National Science Council, Taiwan (NSC 96-2314-B-195-004-MY3) , awarded to HCL and CJH, respectively.
PY - 2013/1
Y1 - 2013/1
N2 - Background: Activation of sympathetic nervous system has a crucial role in mediating the pneumatic tourniquet inflation induced hyperdynamic response. Dexmedetomidine, a selective α2-adrenergic receptor agonist, has potent sympatholytic effects. We conducted this prospective, randomized, placebo-controlled, double-blinded study to elucidate the effects of dexmedetomidine on attenuating the tourniquet-induced hyperdynamic response during general anesthesia. Materials and methods: We included a total of 72 healthy adult patients undergoing elective lower limb surgery. Under general anesthesia, patients were randomized to the dexmedetomidine or the control group (n = 36 in each group). The dexmedetomidine group received a loading dose of dexmedetomidine (0.8 μg·kg-1 over 10 min) followed by continuous infusion of dexmedetomidine (0.4 μg·kg-1.h -1) until tourniquet deflation. The control group received normal saline instead. We compared tourniquet-induced changes in hemodynamic parameters between groups to elucidate the effects of dexmedetomidine. Results: Tourniquet inflation induced significant increases in hemodynamic parameters, including heart rate, systolic arterial pressure, mean arterial pressure, diastolic arterial pressure, rate pressure product, cardiac output, and stroke volume in the control group. The effects of tourniquet inflation on increasing hemodynamic parameters were significantly attenuated by dexmedetomidine: heart rate (P <0.001), systolic arterial pressure (P = 0.002), mean arterial pressure (P = 0.042), diastolic arterial pressure (P = 0.012), rate pressure product (P <0.001), and cardiac output (P = 0.001) of the dexmedetomidine group were significantly lower than those of the control group. However, the stroke volume of these groups was comparable. Conclusions: Dexmedetomidine attenuates tourniquet-induced hyperdynamic response in general anesthesia patients undergoing lower limb surgeries.
AB - Background: Activation of sympathetic nervous system has a crucial role in mediating the pneumatic tourniquet inflation induced hyperdynamic response. Dexmedetomidine, a selective α2-adrenergic receptor agonist, has potent sympatholytic effects. We conducted this prospective, randomized, placebo-controlled, double-blinded study to elucidate the effects of dexmedetomidine on attenuating the tourniquet-induced hyperdynamic response during general anesthesia. Materials and methods: We included a total of 72 healthy adult patients undergoing elective lower limb surgery. Under general anesthesia, patients were randomized to the dexmedetomidine or the control group (n = 36 in each group). The dexmedetomidine group received a loading dose of dexmedetomidine (0.8 μg·kg-1 over 10 min) followed by continuous infusion of dexmedetomidine (0.4 μg·kg-1.h -1) until tourniquet deflation. The control group received normal saline instead. We compared tourniquet-induced changes in hemodynamic parameters between groups to elucidate the effects of dexmedetomidine. Results: Tourniquet inflation induced significant increases in hemodynamic parameters, including heart rate, systolic arterial pressure, mean arterial pressure, diastolic arterial pressure, rate pressure product, cardiac output, and stroke volume in the control group. The effects of tourniquet inflation on increasing hemodynamic parameters were significantly attenuated by dexmedetomidine: heart rate (P <0.001), systolic arterial pressure (P = 0.002), mean arterial pressure (P = 0.042), diastolic arterial pressure (P = 0.012), rate pressure product (P <0.001), and cardiac output (P = 0.001) of the dexmedetomidine group were significantly lower than those of the control group. However, the stroke volume of these groups was comparable. Conclusions: Dexmedetomidine attenuates tourniquet-induced hyperdynamic response in general anesthesia patients undergoing lower limb surgeries.
KW - Dexmedetomidine
KW - Hypertension
KW - Lower limb
KW - Orthopedic surgery
KW - Tourniquet
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U2 - 10.1016/j.jss.2012.01.008
DO - 10.1016/j.jss.2012.01.008
M3 - Article
C2 - 22487388
AN - SCOPUS:84870709209
VL - 179
SP - E99-E106
JO - Journal of Surgical Research
JF - Journal of Surgical Research
SN - 0022-4804
IS - 1
ER -