A prospective study to assess the optimum loading dose of dexmedetomidine to fulfill criteria of anaesthesiologist, surgeon and patient satisfaction in monitored anaesthesia care under local infiltration

Dr Prem Kumari Bhamri; Dr Shipra Singh

Volume : VII, Issue : XI, November - 2017

A prospective study to assess the optimum loading dose of dexmedetomidine to fulfill criteria of anaesthesiologist, surgeon and patient satisfaction in monitored anaesthesia care under local infiltration

Dr Prem Kumari Bhamri, Dr Shipra Singh

Abstract :

Background and aim : Dexmedetomidine , an alpha–2 agonist , a safe sedoanalgesic agent is being used for more than two decades in intensive care and operation theatres . We utilized it’s sedoanalgesic properties for day care surgeries and tried to find out the minimum loading dose that satisfies anaesthesiologist , surgeon and the patient. Methods : 18–50 years , 80 patients, ASA I and II, scheduled for surface surgeries under local infiltration were given dexmedetomidine in incremental doses of 0.2mcg/kg starting from 0.3 mcg/kg with maintenance infusion of 0.2 mcg/kg/hr. Bolus doses of 0.1 mcg/kg were given as and when required but not excceeding the loading dose(LD). We observed patient’s PR , MAP, Ramsay sedation score (RSS) and post operative analgesia duration . Anaesthesiologist’s (ASS), surgeon’s (SSS) and patient’s (PSS) satisfaction scores were evaluated . Results: There was an insignificant but definite fall in MAP and PR with all loading doses . To achieve RSS of 3, maximum bolus doses were required with 0.5mcg/kg whereas no bolus dose was needed in 0.9 and 1.1mcg/kg dose. Maximum ASS, PSS and SSS were achieved at 0.9mcg/kg LD . conclusion : we conclude that 0.9 mcg/kg was the minimum LD required to achieve a sedation score of 3 with ASS,PSS and SSS ≥ 85% and maximum postoperative analgesia duration .