SciELO - Scientific Electronic Library Online

vol.53 issue4Effects of low spinal morphine doses associated to intravenous and oral ketoprofen in patients submitted to cesarean sections author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Revista Brasileira de Anestesiologia

Print version ISSN 0034-7094On-line version ISSN 1806-907X


CHAVES, Thatiany Pereira et al. Hemodynamic and metabolic evaluation of dexmedetomidine and remifentanil continuous infusion in videolaparoscopic cholecystectomy: comparative study. Rev. Bras. Anestesiol. [online]. 2003, vol.53, n.4, pp.419-430. ISSN 0034-7094.

BACKGROUND AND OBJECTIVES: Dexmedetomidine has been used for sedation and as coadjuvant drug in general anesthesia. This study aimed at evaluating cardiovascular and sympathetic-adrenal responses to tracheal intubation and pneumoperitoneum inflation with dexmedetomidine, as compared to remifentanil during anesthesia with sevoflurane for videolaparoscopic cholecystectomy. METHODS: Forty two physical status ASA I or II patients, aged 25 to 55 years, were randomly distributed in two groups: GI and GII. Anesthesia was induced with 1 µ dexmedetomidine (GI) or remifentanil (GII) continuous infusion for 10 minutes, followed by propofol and cisatracurium. Anesthesia was maintained with 0.7 µ dexmedetomidine or 0.5 µ remifentanil continuous infusion and different sevoflurane concentrations. SBP, DBP and HR were recorded in the following moments: M1 - before initial drug infusion; M2 - after end of initial drug infusion; M3 - after tracheal intubation; M4 - before pneumoperitoneum; M5 - after pneumoperitoneum; M6 - five minutes after pneumoperitoneum deflation; M7 - after tracheal extubation. Epinephrine and norepinephrine were dosed in M4, M5 and M6. Sevoflurane expired concentration (EC), EC/MAC ratio and sevoflurane consumption were recorded in M4, M5 and M6. RESULTS: SBP and DBP variations were higher in the dexmedetomidine group in M4 and M5. HR, epinephrine and norepinephrine levels were similar between groups. Sevoflurane EC was higher in M4 and M6 for GI, as well as EC/MAC ratio. There has been a higher sevoflurane consumption in GI, with a trend to less analgesics and anti-emetics consumption. CONCLUSIONS: In the conditions of our study, dexmedetomidine has inhibited catecholamine release during tracheal intubation and pneumoperitoneum, however, has not prevented blood pressure increase in response to peritoneal inflation.

Keywords : ANALGESICS [Opioids]; ANALGESICS [remifentanil]; HIPNOTICS [dexmedetomidine]; SURGERY [Videolaparoscopic]; SURGERY [cholecystectomy].

        · abstract in Portuguese | Spanish     · text in Portuguese     · Portuguese ( pdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License