Effects of Low versus Intermediate Doses of Dexmedetomidine Infusion on Blood Loss, Hemodynamics, and Operative Time in Transsphenoidal Pituitary Tumor Removal: A Prospective Randomized Study
Issued Date
2023-06-07
Resource Type
eISSN
23480548
Scopus ID
2-s2.0-85161885100
Journal Title
Journal of Neuroanaesthesiology and Critical Care
Volume
10
Issue
1
Start Page
39
End Page
45
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Neuroanaesthesiology and Critical Care Vol.10 No.1 (2023) , 39-45
Suggested Citation
Muangman S., Raksakietisak M., Akavipat P., Rushatamukayanunt P., Akkaworakit S., Romkespikun N., Mahatnirunkul P. Effects of Low versus Intermediate Doses of Dexmedetomidine Infusion on Blood Loss, Hemodynamics, and Operative Time in Transsphenoidal Pituitary Tumor Removal: A Prospective Randomized Study. Journal of Neuroanaesthesiology and Critical Care Vol.10 No.1 (2023) , 39-45. 45. doi:10.1055/s-0042-1758747 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87707
Title
Effects of Low versus Intermediate Doses of Dexmedetomidine Infusion on Blood Loss, Hemodynamics, and Operative Time in Transsphenoidal Pituitary Tumor Removal: A Prospective Randomized Study
Author's Affiliation
Other Contributor(s)
Abstract
Background Dexmedetomidine, an alpha-2 agonist, has been widely used as an anesthetic adjunct for transsphenoidal pituitary resection. However, there is no consensus on the appropriate infusion dosage. This study aimed to compare the effects of low (0.2 mcg/kg/h) and intermediate (0.5 mcg/kg/h) dexmedetomidine infusions during anesthetic maintenance on blood loss, hemodynamics, and operating time. Methods A randomized controlled trial involving two centers was conducted. Between December 2015 and November 2019, 80 patients (40 in each group) who underwent elective transsphenoidal pituitary tumor resection were recruited. Dexmedetomidine was administered to group I at a loading dose of 0.5 mcg/kg, followed by 0.2 mcg/kg/h, and to group II at the same loading dose, followed by 0.5 mcg/kg/h. Comparative analyses were performed using the Student’s t-test, repeated-measures analysis of variance, and Mann–Whitney U test; p-values < 0.05 were considered statistically significant. Results Eighty patients were analyzed. Patient demographics were comparable. The difference in intraoperative blood loss between both groups (320 [220–525] vs. 250 [100-487] mL, p ¼ 0.070) was not statistically significant. There were no differences in blood pressure or heart rate between the groups. In group II, the procedure took significantly less time (179 vs. 142 minutes, p ¼ 0.018), with more episodes of transient hypotension (p ¼ 0.034). Conclusion When maintaining anesthesia for transsphenoidal pituitary resection, dexmedetomidine infusions of 0.2 and 0.5 mcg/kg/h showed the same effect on blood loss and hemodynamics; however, significantly more episodes of transient hypotension and shorter operating times were noted with the latter.