TY - JOUR
T1 - The role of the α2-adrenoceptor agonist dexmedetomidine in postsurgical sedation in the intensive care unit
AU - Martin, Eike
AU - Ramsay, Graham
AU - Mantz, Jean
AU - Sum-Ping, S. T John
PY - 2003
Y1 - 2003
N2 - Dexmedetomidine was evaluated for sedation of 401 post-surgical patients in this double-blind, randomized, placebo-controlled, multicenter trial. Dexmedetomidine or saline was started on arrival in the intensive care unit (ICU) (1.0 mcg/kg for 10 minutes), then titrated at 0.2 to 0.7 mcg/kg/h to effect. Patients could be given propofol if necessary. Morphine was administered for pain. Sixty percent of the dexmedetomidine patients required no other sedative to maintain an RSS ≥ 3; 21% required < 50 mg propofol. In contrast, 76% of the control group received propofol; 59% required ≥ 50 mg. Dexmedetomidine patients required significantly less morphine for pain relief (P < .001). Continuously given throughout the ICU stay, dexmedetomidine had no effect on respiratory rate, oxygen saturation, duration of weaning, or times to extubation. Nurses judged the dexmedetomidine patients were easier to manage. Later, fewer dexmedetomidine patients remembered pain or discomfort. The majority of dexmedetomidine patients maintained blood pressures within normal range, without rebound. Hypertension, atelectasis, and rigors occurred more frequently in the control group, while hypotension and bradycardia occurred more frequently in the dexmedetomidine group. Preoperative cardiovascular conditions were not risk factors for dexmedetomidine patients.
AB - Dexmedetomidine was evaluated for sedation of 401 post-surgical patients in this double-blind, randomized, placebo-controlled, multicenter trial. Dexmedetomidine or saline was started on arrival in the intensive care unit (ICU) (1.0 mcg/kg for 10 minutes), then titrated at 0.2 to 0.7 mcg/kg/h to effect. Patients could be given propofol if necessary. Morphine was administered for pain. Sixty percent of the dexmedetomidine patients required no other sedative to maintain an RSS ≥ 3; 21% required < 50 mg propofol. In contrast, 76% of the control group received propofol; 59% required ≥ 50 mg. Dexmedetomidine patients required significantly less morphine for pain relief (P < .001). Continuously given throughout the ICU stay, dexmedetomidine had no effect on respiratory rate, oxygen saturation, duration of weaning, or times to extubation. Nurses judged the dexmedetomidine patients were easier to manage. Later, fewer dexmedetomidine patients remembered pain or discomfort. The majority of dexmedetomidine patients maintained blood pressures within normal range, without rebound. Hypertension, atelectasis, and rigors occurred more frequently in the control group, while hypotension and bradycardia occurred more frequently in the dexmedetomidine group. Preoperative cardiovascular conditions were not risk factors for dexmedetomidine patients.
KW - Anxiety
KW - Cardiac artery bypass graft
KW - Imidazoles
KW - Respiratory system
KW - Sympatholysis
KW - α-adrenoceptors
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U2 - 10.1177/0885066602239122
DO - 10.1177/0885066602239122
M3 - Article
C2 - 15189665
AN - SCOPUS:0142094416
SN - 0885-0666
VL - 18
SP - 29
EP - 41
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 1
ER -