Feld J, Hoffman WE, Paisansathan C, Park H, Ananda RC. Autonomic activity during dexmedetomidine or fentanyl infusion with desflurane anesthesia.
J Clin Anesth 2007;
19:30-6. [PMID:
17321924 DOI:
10.1016/j.jclinane.2006.05.019]
[Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2005] [Revised: 05/11/2006] [Accepted: 05/16/2006] [Indexed: 11/27/2022]
Abstract
STUDY OBJECTIVE
To evaluate autonomic activity with dexmedetomidine or fentanyl infusion and desflurane anesthesia during laparoscopic gastric banding.
STUDY DESIGN
Randomized, single-blinded, open-label study.
SETTING
Operating rooms at a university hospital.
SUBJECTS
40 patients scheduled for laparoscopic gastric banding with a mean body mass index of 50 kg/m2.
INTERVENTIONS
Patients received either dexmedetomidine (0.5 microg/kg given intravenously over 10 minutes, 0.4 microg.kg-1.h-1, n=20) or fentanyl (0.5 microg.kg-1 bolus, 1 microg.kg-1.h-1, n=20) during anesthesia. Response entropy of the electroencephalogram was maintained at 45+/-5 by adjusting end-tidal desflurane concentration.
MEASUREMENTS
In the operating room, blood pressure, heart rate (HR), response entropy, end-tidal desflurane concentration, tone entropy, and power-spectral analysis of HR were measured with the patient awake; 20, 40, and 60 minutes from intubation and the start of drug infusion; and at extubation.
MAIN RESULTS
The mean end-tidal desflurane concentration during anesthesia was 4.0%+/-0.6% with dexmedetomidine and 4.1%+/-0.7% with fentanyl, indicating a similar anesthetic requirement in both groups. Autonomic activity, determined by tone entropy and spectral analysis of HR, decreased by 50% during anesthesia in both groups. The dexmedetomidine group showed a greater decrease in sympathovagal balance during anesthesia.
CONCLUSION
Both dexmedetomidine and fentanyl facilitated anesthesia and attenuated autonomic activity. Dexmedetomidine produced a greater decrease in sympathovagal balance than fentanyl.
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