Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2014.01.003
Brazilian Journal of Anesthesiology
Special Article

Dexmedetomidine and propofol infusion on sedation characteristics in patients undergoing sciatic nerve block in combination with femoral nerve block via anterior approach

Características da sedação com infusão de dexmedetomidina e propofol em pacientes submetidos ao bloqueio do nervo ciático em combinação com bloqueio do nervo femoral via abordagem anterior

Abdulkadir Yektaş; ; Funda Gümüş; ; Ayş; in Alagol

http://dx.doi.org/10.1016/j.bjane.2014.01.003 Braz J Anesthesiol, vol.65, n5, p.371-378, 2015
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Abstract

ABSTRACTOBJECTIVE: Dexmedetomidine is an a-2 adrenergic agonist having wide range of effects including sedation in mammalian brain, and has analgesic as well as sympatholytic properties. This study aimed to compare the effects of dexmedetomidine and propofol infusion on sedation characteristics in patients undergoing combined sciatic nerve and femoral nerve block via anterior approach for lower limb orthopedic procedure.METHODS: Forty patients, who were between 18 and 65 years old, this study was made at anesthesiology clinic of Bagcilar training and research hospital in 08 September 2011 to 07 June 2012, and underwent surgical procedure due to fractures lateral and medial malleol, were included. Sciatic nerve and femoral nerve block were conducted with an anterior approach on all patients included in the study, with an ultrasonography. The patients were randomly divided into dexmedetomidine [Group D (n = 20); 0.5 µg kg-1 h-1] and propofol [Group P (n = 20); 3 mg kg-1 h-1] infusion groups.RESULTS: The vital findings and intra-operative Ramsay sedation scale values were similar in both groups. Time taken for sedation to start and time required for sedation to become over of Group D were significantly higher than those of Group P (p < 0.001 for each).CONCLUSIONS: Substitution of dexmedetomidine instead of propofol prolongs the times to start of sedation, the times to end of sedation and duration of sedation.

Keywords

Dexmedetomidine, Propofol, Sedation, Nerve block

Resumo

RESUMOOBJETIVO: Dexmedetomidina é um agonista a2-adrenérgico que tem uma ampla gama de efeitos, incluindo sedação do cérebro de mamíferos, e propriedades tanto analgésicas quanto simpatolíticas. Este estudo teve como objetivo comparar os efeitos de dexmedetomidina e propofol sobre as características da sedação em pacientes submetidos ao bloqueio combinado dos nervos ciático e femoral via abordagem anterior em procedimento ortopédico de membro inferior.MÉTODOS: Quarenta pacientes, entre 18 e 65 anos, submetidos a procedimento cirúrgico por causa de fraturas lateral e medial do maléolo foram incluídos neste estudo, conduzido no Departamento de Anestesiologia do Hospital de Ensino e Pesquisa Bagcilar de 8 de setembro de 2011 a 7 de junho de 2012. O bloqueio dos nervos ciático e femoral foi feito via abordagem anterior em todos os pacientes incluídos no estudo, com ultrassonografia. Os pacientes foram randomicamente divididos em dois grupos para as infusões de: dexmedetomidina (grupo D [n = 20]; 0,5 µg kg-1 h-1) e propofol (grupo P [n = 20]; 35 mg kg-1 h-1).RESULTADOS: Os sinais vitais e os valores da escala de sedação de Ramsay no período intraoperatório foram semelhantes em ambos os grupos. Os tempos de início e término da sedação no grupo D foram significativamente maiores do que os do grupo P (p < 0,001, respectivamente).CONCLUSÃO: O uso de dexmedetomidina em vez de propofol prolonga os tempos de início, término e duração da sedação.

Palavras-chave

Dexmedetomidina, Propofol, Sedação, Bloqueio de nervo

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