Benign Prostate Hyperplasia Clinical Trial
Recently many studies reported that intraoperative dexmedetomidine administration undergoing
spinal anesthesia give a satisfactory sedation in elderly patients and cause less
respiratory depressions compared other sedatives(e.g. benzodiazepine) But the optimal dose
of dexmedetomidine for sedative effect in elderly patients undergoing spinal anesthesia was
not got general consensus.
The investigators hypothesized that the dose requirements would be lower than in elderly
patients than young patients. Furthermore, intrathecal small dose opioids enhance the
analgesia provided by bupivacaine due to synergistic effects and it would reduce the dose of
dexmedetomidine.
The purpose of this study was to determine the dose of dexmedetomidine to provide
satisfactory sedation undergoing spinal anesthesia with or without additive small dose
intrathecal opioids.
Elderly patients(65~85 years old) undergoing TURP or TURB were enrolled in this
single-blinded study. Forty patients were randomly assigned to receive intrathecal
hyperbaric bupivacaine 6mg coadministered with 20mcg fentanyl or placebo normal saline
0.4cc. After the induction (bilateral T10 sensory level to pinprick within 5 mins of
intrathecal drug administration), continuous intravenous dexmedetomidine was started in dose
of 0.8, 0.6, 0.5, 0.4, 0.3, or 0.2mcg. Successful sedation was defined as OASS score 3 or 4
within 20 minutes of dexmedetomidine infusion. The dose of dexmedetomidine was selected for
each patient according to an up and down method. Intraoperative arterial pressure, heart
rate, and bispectral index was compared. Postoperative pain score, the time for the
regression of sensory and motor was recorded for further analysis.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Supportive Care
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