O. Erkola et al., COMPARISON OF INTRAMUSCULAR DEXMEDETOMIDINE AND MIDAZOLAM PREMEDICATION FOR ELECTIVE ABDOMINAL HYSTERECTOMY, Anesthesia and analgesia, 79(4), 1994, pp. 646-653
The purpose of this study was to compare the perioperative effects of
the intramuscular (IM) alpha(2), agonist, dexmedetomidine (DEX), and m
idazolam (MID) premedication. The study comprised 192 women (64 per gr
oup) scheduled for abdominal hysterectomy. The doses of the study drug
s were chosen to obtain equal sedative effects. The three groups were:
1) IM DEX (2.5 mu g/kg) and intravenous (IV) placebo (DexPla group),
2) IM DEX and IV fentanyl (FENT) (1.5 mu g/kg) (DexFent group), and 3)
IM MID (0.08 mg/kg) and IV FENT (MidFent group). IM drugs were admini
stered 45-90 min before induction of anesthesia. Preoperative sedation
and anxiolysis after DEX was comparable to that after MID. The maximu
m arterial blood pressure response to endotracheal intubation was blun
ted in the DexFent group, while in the two other groups blood pressure
increased 30-34 mm Hg after endotracheal intubation. The mean isoflur
ane concentration during surgery was 0.14% in the DexFent group, 0.24%
in the DexPla group, and 0.34% in the MidFent group (P < 0.001). Duri
ng surgery, bradycardia (heart rate < 40 bpm) was observed in 6.2% of
DEX patients, and no MID patients, whereas postoperatively 14.1% of DE
X patients and 1.6% of MID patients had bradycardia. Fewer patients su
ffered from postoperative shivering after DEX (10%) than after MID (52
%). We conclude that DEX has many desirable effects, but side effects
such as bradycardia may limit its routine use in ASA physical status I
-II patients.