The Effects of Dexmedetomidine and Remifentanil on Hemodynamic Stability and Analgesic Requirement After Craniotomy: A Randomized Controlled Trial

Journal of Neurosurgical Anesthesiology
Shobana RajanRafi Avitsian

Abstract

Anesthesia for craniotomies should blunt responses to noxious stimuli, whereas subsequently leaving patients sufficiently alert for early neurological evaluation. The aim was to compare postoperative blood pressure control, pain, and opioid requirement after anesthesia with dexmedetomidine versus remifentanil. We therefore tested 2 primary hypotheses: (1) intraoperative administration of dexmedetomidine provides better control of postoperative blood pressure than remifentanil; and (2) patients given dexmedetomidine have less postoperative pain and use less opioid. Adults having elective brain tumor excisions under balanced general anesthesia with endotracheal intubation were randomized to an infusion of remifentanil (0.08 to 0.15 μg/kg/min, n=71) or dexmedetomidine (0.2 to 0.7 μg/kg/h, n=68). Patients also received propofol, rocuronium, fentanyl, and sevoflurane. The mean arterial pressure (MAP) and pain were recorded at 15, 30, 45, 60, and 90 postoperative minutes. Outcomes were assessed with joint hypothesis testing, evaluating noninferiority and superiority. Compared with remifentanil, the use of dexmedetomidine was associated with reduced postoperative MAP (88±12 vs. 98±11 mm Hg), with estimated mean difference (97.5% confi...Continue Reading

References

Dec 1, 1988·Clinical Pharmacology and Therapeutics·B E GibsonR F Cucchiara
Mar 1, 1987·British Journal of Anaesthesia·A J ShribmanK J Achola
Jun 1, 1983·The American Journal of Psychiatry·R KatzmanH Schimmel
Nov 1, 1995·Anesthesiology·A KapilaR L Smith
Feb 1, 1995·Journal of Clinical Anesthesia·J A Aldrete
Oct 8, 1999·Anesthesia and Analgesia·Peter S A GlassScott Howell
Mar 7, 2000·Anesthesia and Analgesia·J E HallT J Ebert
Oct 7, 2004·European Journal of Pharmacology·Daqing MaMervyn Maze
Dec 8, 2004·CNS Drugs·Richard Beers, Enrico Camporesi
Mar 2, 2006·Anesthesiology·Martin S Angst, J David Clark
Mar 7, 2006·Journal of Clinical Anesthesia·James M FeldRanga C Ananda
Sep 22, 2007·Nursing in Critical Care·Panagiotis KiekkasGeorge Baltopoulos
Mar 17, 2010·Journal of Geriatric Psychiatry and Neurology·Victoria R QueallyThomas M McMillan
May 19, 2010·Journal of Neurosurgical Anesthesiology·Christine MordhorstKristin Engelhard
Jan 18, 2012·Revista brasileira de anestesiologia·Joana Afonso, Flávio Reis
Mar 5, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Shobana RajanRafi Avitsian
Jun 30, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Ke PengFuhai Ji
Dec 11, 2014·Journal of Neurosurgical Anesthesiology·Kadarapura N GopalakrishnaArimanickam Ganesamoorthi
Mar 15, 2015·Clinical Therapeutics·Ke PengFu-hai Ji

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Citations

Sep 9, 2016·Current Neurology and Neuroscience Reports·Lauren K DunnMarcel E Durieux
Feb 23, 2017·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier
Dec 21, 2016·Pain Practice : the Official Journal of World Institute of Pain·Georgia G TsaousiFederico Bilotta
Mar 9, 2018·Current Opinion in Critical Care·Athir MoradAlexander Papangelou
Mar 10, 2018·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak, William L Lanier
Dec 30, 2017·Surgical Neurology International·Susana Vacas, Barbara Van de Wiele
Oct 27, 2018·Journal of Neurosurgical Anesthesiology·Nan LinAdrian W Gelb
Nov 21, 2019·The Cochrane Database of Systematic Reviews·Imelda M GalvinIan Gilron
Jul 12, 2017·Current Opinion in Anaesthesiology·Georgia G TsaousiFederico Bilotta
Apr 3, 2020·Current Pain and Headache Reports·Alan David KayeElyse M Cornett
Feb 11, 2021·Anesthesiology Clinics·Yifan Xu, Kamila Vagnerova

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