Comparison of remifentanil with dexmedetomidine for monitored anaesthesia care in elderly patients during vertebroplasty and kyphoplasty.

Abstract

OBJECTIVES:

This clinical trial is registered at ClinicalTrials.gov. (NCT02476981)This randomized, prospective double-blind study compared remifentanil with dexmedetomidine for monitored anaesthesia care during minimally invasive corrections of vertebral compression fractures (vertebroplasty or kyphoplasty).

METHODS:

Patients > 65 years of age with American Society of Anesthesiologists (ASA) classification I-III, scheduled for vertebroplasty or kyphoplasty under monitored anaesthesia care, received remifentanil (i.v. infusion 1-5 µg/kg/h) or dexmedetomidine (loading dose 0.3-0.4 µg/kg followed by i.v. infusion 0.2-1 µg/kg/h) to maintain observer's assessment of alertness/sedation (OAA/S) scale <4 during the procedure.

RESULTS:

There were no statistically significant differences in demographic data between the remifentanil (n = 37) and dexmedetomidine groups (n = 38). Patients on dexmedetomidine experienced lower mean arterial pressure (MAP) and heart rate (HR), and higher SpO2 values, than patients on remifentanil. Compared with dexmedetomidine, remifentanil produced more respiratory depression, oxygen desaturation, and reduced the need for additional intraoperative opioids. There were no significant between-group differences in terms of recovery time, investigators' satisfaction scores, or patients' overall pain experiences.

CONCLUSIONS:

During monitored anaesthesia care, dexmedetomidine provides less respiratory depression, lower MAP and HR, but also less analgesic effect than remifentanil in elderly patients undergoing vertebroplasty or kyphoplasty.

• Authors: Jung Min Lee, Soo Kyung Lee, Sang Jun Lee, Woon Suk Hwang, Sung Wook Jang, Eun Young Park
• Journal: The Journal of international medical research (J Int Med Res) Vol. 44 Issue 2 Pg. 307-16 (Apr 2016) ISSN: 1473-2300 [Electronic] England
• PMID: 26912506 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: © The Author(s) 2016.

Chemical References

• Analgesics, Non-Narcotic
• Anesthetics, Intravenous
• Piperidines
• Dexmedetomidine
• Remifentanil

Topics

• Aged
• Aged, 80 and over
• Analgesics, Non-Narcotic (therapeutic use)
• Anesthetics, Intravenous (therapeutic use)
• Blood Pressure (drug effects)
• Conscious Sedation (methods)
• Dexmedetomidine (therapeutic use)
• Double-Blind Method
• Female
• Heart Rate (drug effects)
• Humans
• Kyphoplasty
• Male
• Middle Aged
• Piperidines (therapeutic use)
• Prospective Studies
• Remifentanil