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Revista Brasileira de Anestesiologia

On-line version ISSN 1806-907X


MAGALHAES, Edno; GOVEIA, Cátia Sousa; LADEIRA, Luís Cláudio de Araújo  and  ESPINDOLA, Beatriz Vieira. Relationship between dexmedetomidine continuous infusion and end-tidal sevoflurane concentration, monitored by bispectral analysis. Rev. Bras. Anestesiol. [online]. 2004, vol.54, n.3, pp. 303-310. ISSN 1806-907X.

BACKGROUND AND OBJECTIVES: General inhalational anesthesia associated with intravenous agents provides analgesia and hypnosis of better quality. Dexmedetomidine is a specific a2-adrenergic agonist with these characteristics and is known by providing hemodynamic stability. This study aimed at evaluating the effects of dexmedetomidine continuous infusion on end-tidal sevoflurane concentration (ETsevo) in general anesthesia, monitored by EEG spectral index (BIS). METHODS: Participated in this prospective study 24 adult patients of both genders, physical status ASA I and II submitted to elective surgery under general anesthesia and monitored by ECG, BP, SpO2, PETCO2, ETsevo and BIS. Intravenous anesthesia was induced with alfentanil (30 µ, thiopental (5 and vecuronium (0.1, followed by tracheal intubation. Then, sevoflurane (to maintain BIS between 40 and 60), controlled ventilation with tidal volume of 10 and PETCO2 between 35 and 45 mmHg were started. During   maintenance, 60 minutes after anesthetic induction (T60), continuous dexmedetomidine infusion was started in 2 phases: initial infusion (1 µ in 20 minutes; and maintenance infusion (0.5 µ Sevoflurane concentration was adjusted to maintain BIS between 40 and 60. BP, HR, ETsevo, SpO2, PETCO2 and BIS were evaluated in the following moments before anesthetic induction (M-15), M15, M45, M75, M105 and M120. RESULTS: The association of dexmedetomidine to general anesthesia with sevoflurane     provided statistically significant ETsevo decrease (p < 0.05) from M45 (1.604 ± 0.485) to M105 (1.073 ± 0.457), and from M45 (1.604 ± 0.485) to M120 (1.159 ± 0.475). Hemodynamic parameters have shown statistically significant differences (p < 0.05), however without clinical repercussions. CONCLUSIONS: The association of dexmedetomidine continuous infusion (0,5 µ to inhalational anesthesia with sevoflurane provided end-tidal sevoflurane concentration decrease while maintaining hemodynamic stability.

Keywords : ANALGESICS [dexmedetomidine]; ANESTHETICS [Volatile]; ANESTHETICS [sevoflurane].

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