NDLI: Dexmedetomidine: an alternative for epidural anesthesia in tension-free vaginal-tape surgery.

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Dexmedetomidine: an alternative for epidural anesthesia in tension-free vaginal-tape surgery.

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Dexmedetomidine: an alternative for epidural anesthesia in tension-free vaginal-tape surgery.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Turan, Alparslan Sen, Hüseyin Sizlan, Ali Yanarates, Omer Ozkan, Sezai Koyuncu, Onur Dagli, Güner
Description	Country affiliation: United States Author Affiliation: Turan A ( The Cleveland Clinic, 9500 Euclid Avenue, P-77, Department of Outcomes Research, Anesthesiology Institute, Cleveland, OH 44195, USA. turana@ccf.org)
Abstract	PURPOSE: Anesthetic management of tension-free vaginal-tape (TVT) procedures is sometimes difficult to deal with, especially when surgeons request a cough test. Dexmedetomidine has unique sedative and analgesic properties while having minimal respiratory effects, making it suitable for perioperative use in monitored anesthesia care. We aimed to compare dexmedetomidine and epidural anesthesia in TVT patients. METHODS: Forty-nine women [American Society of Anesthesiologists (ASA 1-3)] with genuine stress incontinence confirmed by preoperative bladder function studies were included in this double-blind, randomized study. The patients were randomly assigned to one of two groups: group D received 0.5 µg/kg dexmedetomidine IV applied as bolus over 10 min and continued with 0.5 µg/kg/h infusion, and local anesthesia (lidocaine 2% with epinephrine) performed by the surgeon. Group E received epidural anesthesia with 15 ml of 0.25% bupivacaine + 100 µg fentanyl. Patients were monitored every 5 min for mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation, respiratory rate, sedation, and intraoperative and postoperative pain. Ability to cough was also evaluated by the surgeon. RESULTS: There was no difference in ability to cough, and this was evaluated by the surgeon as adequate, and there was no difference in scores between groups. Significant decreases in MAP and HR were observed 10 min after the start of surgery in group D compared with group E, and they were significantly decreased until first and second postoperative hours, respectively (p < 0.05). None of the patients had respiratory rate decrease or apnea. Side effects encountered postoperatively were similar. CONCLUSION: Dexmedetomidine can be an alternative to epidural anesthesia in TVT procedure requiring cough test.
File Format	HTM / HTML
ISSN	09138668
Issue Number	3
Volume Number	25
e-ISSN	14388359
Journal	Journal of Anesthesia
Language	English
Publisher	Springer
Publisher Date	2011-06-01
Publisher Place	Japan
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Anesthesia, Epidural Dexmedetomidine Gynecologic Surgical Procedures Hypnotics And Sedatives Suburethral Slings Vagina Surgery Adverse Effects Cough Physiopathology Double-blind Method Female Hemodynamics Drug Effects Physiology Humans Hypotension Drug Therapy Intraoperative Complications Epidemiology Intraoperative Period Isotonic Solutions Middle Aged Pain Measurement Pain, Postoperative Psychology Plasma Substitutes Postoperative Nausea And Vomiting Respiratory Mechanics Urinary Incontinence Comparative Study Journal Article Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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Dexmedetomidine: an alternative for epidural anesthesia in tension-free vaginal-tape surgery.