Home E-Weekly April 15, 2014

A Supplemental Sedative Can Reduce Anesthesia Amounts

Published: April 14, 2014

Patients whose anesthesia was supplemented with the sedative dexmedetomidine needed significantly less propofol or remifentanil for their surgical procedures and experienced significantly longer post-operative analgesia, a study recently published in Anesthesia & Analgesia finds.

Sixty patients were randomly assigned to receive either a supplement of dexmedetomidine or a placebo with their sedative. Those induced with propofol and the additional sedative needed about 30% less propofol both for induction and maintenance. Those given supplemented remifentanil needed about 25% less for induction, although maintenance required about the same amount. Brain activity was monitored to measure the anesthesia levels required.

The supplement's effects were noticeable into recovery. Patients in the dexmedetomidine group requested morphine after a median of 4 hours, versus only 1 hour for the placebo group.

Dexmedetomidine is a central alpha-2 adrenergic agonist often given to patients in ICUs. Unlike many anesthetics, it doesn't cause respiratory depression. Its use as a potential adjuvant is bolstered by the fact that it employs a different mechanism than propofol and other anesthetics.

Jim Burger

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