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Background and Aims Dexmedetomidine is a centrally acting alpha-2 receptor agonist has different beneficial effects when administered epidurally. This randomized controlled study was designed to demonstrate that epidural dexmedetomidine decrease total dose anesthetics during general anesthesia.
Methods 45 patients undergoing general anesthesia for elective colon resection due to cancer were randomly allocated into two groups. Gr.1 had 1 μg·kg-1 dexmedetomidine epidural with ropivacaine 30 mg 25 minutes before induction to general anesthesia and Gr.2 was given fentanyl 100 μg with ropivacaine 30 mg. The depth of anesthesia was guided by BIS with target level between 40 and 60. The consumption of propofol, i.v. fentanyl and muscle relaxants were measured.
Results 22 patients with dexmedetomidine and 23 with fentanyl were enrolled in the study. Patients did not differ by age, p=0,7471. Duration of anesthesia in Gr.1 was 171,7±38 min, and the Gr.2 155,7±45,4, (p=0,4902). The dose of Atracurium was lower in Gr.1 (1,05±0,3 mg/kg) then Gr.2 (1,18±0,4 mg/kg), p=0,6796. Duration of awakening in Gr.1 was longer (16,4±8,2 min) than in Gr.2 (10,7±2,6 min), p=0,0555. BIS values in Gr.1 in the was 41,1±11, and in the Gr.2 45,2±10, p=0,0004. The total dose of propofol was lower in Gr.1 (1,28±0,2 mg/kg) than in Gr.2, (1,77±0,7 mg/kg), p=0,0108. The total dose of fentanyl was less in Gr.1 (5,46±4,4 μg/kg), than in Gr.2 (8,73±3,8 μg/kg), p=0,0171.
Conclusions epidural dexmedetomidine decreases the doses of propofol and fentanyl during general anesthesia, but increases the duration of awakening time without increasing doses of muscle relaxants.
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