Dexmedetomidine and Remifentanil as Adjunct to Regional Anesthesia, a Randomized Clinical Trial

Dr. Nihal Kirman¹, Dr. Ömer Burak Küçükebe², Dr. Ruslan Abdullayev²*, Dr. Esra Aksoy³ and Assoc. Prof. Dr. Nermin Göğüş⁴

¹İzmir Tepecik Research Hospital, Anesthesiology and Reanimation Department İzmir, Turkey.

²Adiyaman University Research Hospital, Anesthesiology and Reanimation Department.

³Ankara Numune Research Hospital, Anesthesiology and Reanimation Department, Ankara, Turkey.

⁴Hitit University Medical Faculty, Anesthesiology and Reanimation Department, Ankara, Turkey.

*Corresponding Author E-mail: ruslan_jnr@hotmail.com; Tel:+905063010833

Accepted 02 September, 2014

Abstract

Spinal anesthesia is one of the required methods for orthopedic surgery. It is of quite importance to decrease anxiety of awake patient during an operation under spinal anesthesia. Plenty of drugs have been used for this purpose. We aimed to compare dexmedetomidine and remifentanil administered for sedation and evaluate it by OAA/S and BIS. Patients aged 18-65 years undergoing orthopedic knee surgery under spinal anesthesia were divided into two groups. Group D received dexmedetomidine 1 µg/kg bolus, then 0.2 µg/kg^/h infusion; group R received remifentanil 0.5 µg/kg bolus, then 3 µg/kg^/h infusion. Hemodynamic variables and respiratory parameters were recorded. Sedation level was measured by OAA/S and BIS. There was no marked difference in hemodynamic parameters between the two groups, but group D had higher OAA/S and lower BIS scores. Although respiration was depressed more in group R, recovery time was shorter in group D. Both remifentanil and dexmedetomidine can be used for sedation provided that the respiratory parameters are monitored. While faster recovery was provided by remifentanil, deeper sedation was achieved by dexmedetomidine.

Keywords: BIS, dexmedetomidine, remifentanil, sedation, OAA/S.