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Adequate sedation with single-dose dexmedetomidine in patients undergoing transurethral resection of the prostate with spinal anaesthesia: a dose-response study by age group

 Jeongmin Kim  ;  Won Oak Kim  ;  Hye-Bin Kim  ;  Hae Keum Kil 
 BMC ANESTHESIOLOGY, Vol.15 : 17, 2015 
Journal Title
Issue Date
Adrenergic alpha-2 Receptor Agonists/administration & dosage* ; Adult ; Age Factors ; Aged ; Anesthesia, Spinal/methods ; Dexmedetomidine/administration & dosage* ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Hemodynamics/drug effects ; Humans ; Hypnotics and Sedatives/administration & dosage* ; Male ; Middle Aged ; Transurethral Resection of Prostate/methods*
Dexmedetomidine ; Aged ; Sedation ; Spinal anesthesia
BACKGROUND: Dexmedetomidine (DMT), a highly selective α2-adrenoceptor agonist, has been used safely as a sedative in patients under regional anesthesia. The purpose of this study was to determine the 50% effective dose (ED50) of single-dose DMT to induce adequate light sedation in elderly patients in comparison with younger patients undergoing transurethral resection of the prostate (TURP) with spinal anesthesia. METHODS: Forty-two male patients were recruited. The young age group (Group Y) included patients 45 to 64 years old and the old age group (Group O) included patients 65 to 78 years old. After the spinal anesthesia was performed, a pre-calculated dose of DMT was administered for 10 min. The Observer's Assessment of Alertness/Sedation (OAA/S) scale, bispectral index score (BIS) were assessed then at 2-min intervals for 20 min. A modified Dixon's up-and-down method was used to determine the ED50 of the drug for light sedation (OAA/S score 3/4). In the recovery room, regression times of the motor and sensory blocks were recorded. RESULTS: The ED50 of DMT was 0.25 (95% C.I. 0.15-0.35) μg/kg in Group O and 0.35 (95% C.I. 0.35-0.45) μg/kg in Group Y (p = 0.002). The ED95 was 33% lower in Group O compare with Group Y (0.38 (95% C.I. 0.29-0.39) μg/kg vs. 0.57 (95% C.I. 0.49-0.59) μg/kg). The regression time of sensory block was longer in Group O than in Group Y (109.0 ± 40.2 min vs. 80.0 ± 31.6 min) (p = 0.014). CONCLUSION: The single-dose of DMT for light sedation was lower by 21% in Group O compare with Group Y underwent TURP with spinal anesthesia.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kil, Hae Keum(길혜금)
Kim, Won Oak(김원옥)
Kim, Jeongmin(김정민) ORCID logo https://orcid.org/0000-0002-0468-8012
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