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The effects of loading dose administration rate of dexmedetomidine on sedation and dexmedetomidine requirement in elderly patients undergoing spinal anesthesia
Anesth Pain Med 2018;13(3):264-70
Published online July 31, 2018
© 2018 The Korean Society of Anesthesiologists.

Hsi Chiang Kung, Chia Chi Cheng, Dong Hee Kang, Hyung Joo Jeong, Yu Som Shin, Doo Sik Kim, Sie Jeong Ryu, Kyung Han Kim, and Ju Deok Kim
Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, Busan, Korea
Correspondence to: Ju Deok Kim, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 49267, Korea Tel: 82-51-990-6283 Fax: 82-51-254-2504 E-mail: uamyfriends@hanmail.net ORCID http://orcid.org/0000-0002-9236-5183
Received July 19, 2017; Revised October 16, 2017; Accepted November 22, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: This study evaluated the effect of decrease in loading dose administration rate of dexmedetomidine (DMT) on sedation and DMT requirement in elderly patients.
Methods: Fifty-eight patients over 65 years old with ASA I–II who were planned to receive DMT sedation during spinal anesthesia were randomly assigned to two groups. Group S (n = 29) received a 0.5 μg/kg DMT loading dose over 20 minutes, while group C (n = 29) received the DMT loading dose over 10 minutes. Then, both groups received a continuous infusion of 0.4 μg/kg/h. The sedative status was recorded before and at 5, 10, 15, 20, 25, and 30 minutes after administration of DMT and at the end of the anesthesia according to the Ramsay sedation scale (RSS). Also, the time to reach RSS-3 (patients asleep, responsive to commands) and the dose of DMT until reaching RSS-3 were recorded.
Results: The time to reach RSS-3 was similar between the two groups (group S = 16.0 ± 4.3 minutes vs. group C = 15.5 ± 4.2 minutes, P = 0.673). However, the DMT required to reach RSS-3 in group S was significantly lower than that in group C (23.3 ± 7.1 vs. 32.5 ± 6.0 μg, P < 0.001). There was no difference in RSS between the two groups from the administration of DMT to the end of the anesthesia (P = 0.927).
Conclusions: Decreasing the administration rate of the DMT loading dose did not delay the onset of RSS-3 sedation and reduced the DMT requirement in elderly patients.
Key Words : Adrenergic alpha-2 receptor agonists, Aged, Dexmedetomidine, Hypnotics and sedatives, Spinal anesthesia.


July 2018, 13 (3)
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