Dexmedetomidine premedication of outpatients under IVRA

ABSTRACT

Dexmedetomidine is approximately 8 times more selective toward the alpha-2-adrenoceptors than clonidine. It induces analgesia in patients and decreases anesthetic requirements by up to 90%. The current study aimed to evaluate the effects of dexmedetomidine premedication on tourniquet pain, intraoperative-postoperative analgesic requirements, sedation levels, quality of anesthesia, and the hemodynamic parameters when used as a single dose before intravenous regional anesthesia [IVRA]. Fifty-four patients undergoing hand surgery [carpal tunnel and tendon release] were randomly divided into 2 groups for IVRA. IVRA was performed with 40 mL of 0. 5% lidocaine in both groups. A single dose of dexmedetomidine 0. 5 microg/kg in 20 mL saline was administered to group D [n=27] and placebo solution 20 mL to group C [n=27] through the non-IVRA catheter 15 minutes before IVRA. Sensory and motor block onset and recovery time, hemodynamic variables, tourniquet pain, analgesic requirements according to verbal rating scale [VRS] and visual analog scale[VAS], sedation score, and anesthesia quality were recorded in the intraoperative and postoperative period. Improved quality of anesthesia, reduced postoperative pain scores, and total analgesic requirements were found in group D during postoperative period. Additionally, the patients experienced a higher degree of sedation during intraoperative and postoperative period. The premedication of 0. 5 microg/kg low dose dexmedetomidine before IVRA improves the quality of anesthesia and decreases the postoperative analgesic requirement of outpatients undergoing hand surgery without any serious side effects