International Journal of Pharmacology and Clinical Sciences, 2013, 2, 3, 75-81.
Published: September 2013
Type: Research Article
Authors: Manasa CR, Padma L, Shivshankar, and Ranjani Ramanujam
Author(s) affiliations:
Manasa CR1*, Padma L2, Shivshankar3, Ranjani Ramanujam1
1Post graduate, Department of Pharmacology, 2Professor and Head, Department of Pharmacology, 3Professor, Department of Anaesthesia, Dr.B.R.Ambedkar Medical College, Kadugondanahalli, Bangalore, India.
Abstract
Background: In the post-operative period, it has always been an important consideration for clinicians, to keep the patient comfortable, calm and pain-free. So there is a constant need for an ideal sedative for postoperative patients. Alpha 2 adrenoreceptor agonists such as dexmedetomidine could provide an answer to this problem because they have several relevant physiological properties like sedation, anxiolysis, analgesia and arousability. Hence, the current study was undertaken to evaluate the efficacy of dexmedetomidine in post-operative patients in order to avoid polypharmacy. Materials and Methods: Thirty patients who were operated under general anesthesia electively were randomly selected. All patients received 1 μg/kg body weight of dexmedetomidine intravenously with normal saline making up to 10 ml over 20 minutes. If the verbal numerical scale (VNS) of pain was mild (i.e. 1 to 3) one hour after extubation. The patients were assessed for degree and duration of sedation, hemodynamic changes, episodes of side effects, requirement of analgesics at every 5 min for first 30 min, every 10 min for next 1hr, every 15 min for next 1 h, and every 30 min for next 1h, every 1 h for 3h and 6th hourly till 24h. The need for rescue analgesic was noted. Results: The mean duration of sedation was 129.6 ± 41.02 min, degree of sedation was -1 at 30 min, duration of analgesia 241.5 min, and mean degree of analgesia was 0 at 30 min, mean degree of sedation was -1. Mean time of administration of rescue analgesia was 170 min. Mean heart rate was 67.8 ± 5.24/min and mean arterial pressure was 78.0 ± 8.97mm of Hg, mean respiratory rate was 15.8 ± 2.33 breaths/min, mean partial pressure of oxygen SpO2 was 99.5 ± 0.56%. No patient had any episode of shivering, vomiting, hypotension, and respiratory depression. Conclusion: Single IV dose of dexmedetomidine could provide adequate sedative, analgesic, and anxiolytic effects with no accompanying respiratory depression, thereby minimizing polypharmacy.