Bradycardia Clinical Trial
Dexmedetomidine is a selective α2 adrenergic receptor antagonist, which has little effect on respiratory suppression used as sedative agent. Also, dexmedetomidine has been reported to prolong the anesthesia time when used with patients undergoing spinal anesthesia. However, dexmedetomidine has sympathetic effect which can cause hypotension and bradycardia dose dependently. Therefore, this study is aimed to evaluate the effectiveness of premedication of anticholinergic agents on vital sign in patients undergoing spinal anesthesia.
Before entering the operation room, patients are randomized in one group (A or C). For
sedative premedication, all patients will be injected intramuscularly with midazolam 1mg.
After entering the operation room, all patients will be monitored blood pressure, ECG and
oxygen saturation. Before induction of spinal anesthesia, all patients will be loaded with
plasma solution 5mL/kg. After induction of spinal anesthesia, block level will be checked.
After fixation of block level, the loading dose(0.6ug/kg) of dexmedetomidine which is
diluted with normal saline as 4ug/mL would be started for 10 minutes. However, just before
starting dexmedetomidine,atropine .01~0.03mg/kg up to 0.5mg would be injected in group A.
Otherwise normal saline 0.5mL would be injected in group C. The syringed would be blinding
not to be noticed. After loading of dexmedetomidine, the diluted solution would be injected
with 0.25ug/kg/hr until the end of the surgery. Every patients undergoing sedation would be
applied the oxygen by nasal prong.
The heart rate decreasing 30% from initial heart rate or under 40/min would be regarded as
bradycardia needing treatment, and atropine 0.5mg will be injected intravenously. Systolic
blood pressure decreasing 30% from basal blood pressure or under 90 mm Hg would be regarded
as hypotension needing treatment, and ephedrine 5mg will be injected intravenously. The
number of medication treated would be noted.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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