Núñez-Ponce JC, Martínez-Segura RT, Santillán-Paredes H, Escobar ENF, Silva JA

Language: Spanish
References: 9
Page: 163-170
PDF size: 254.47 Kb.

ABSTRACT

Introduction: In recent years the geriatric population has increased considerably and thus their life expectancy, fear of the unknown, poor control of comorbidities and pain makes them susceptible to complications ranging from tachycardia hypertensive crisis and anxiety through Stroke Infarct or cerebrovascular accident, hence the importance of reducing risk factors such as hypertension and tachycardia in the perioperative period. Material and methods: Experimental study was conducted, prospective, transversal and comparative. In order to determine the benefits of sedation with dexmedetomidine during cataract resection in patients PEMEX North Central Hospital. Once endorsed by the ethics committee included all patients scheduled for cataract resection from January to April of 2013 in the North Central Hospital of PEMEX, age greater than or equal to 50 years, ASA I-III, were excluded patients who underwent cataract surgery under 49 years, ASA increased to IV, chronic use of benzodiazepines, chronic alcoholism or drug addiction. The study included a total sample of 60 patients were randomly divided into three groups: Group A received no sedation and only performed vital signs monitoring and trailing, Groups B and C were given dexmedetomidine 0.5 µg/kg/h and 0.7 µg/kg/h, 15 minutes before admission to the operating room, the infusion was continued for an hour or until the end of surgery, whichever came first. Was performed taking vital signs on arrival at preoperative (baseline), 15 minutes after the start of infusion (baseline), when applying the retrobulbar boque and after the procedure (final). We recorded the Ramsay sedation scale and the use of analgesics in the postoperative period for each group. Statistical analysis design: Data were analyzed according to the average, standard deviation and percentages Student T with the statistical program SPSS version 17. Results: The benefits of dexmedetomidine sedation during resection of cataract are reflected in a statistically significant decrease in heart rate and mean arterial blood pressure relative to patients not receiving sedation without causing respiratory depression. Conclusions: Sedation with dexmedetomidine 0.5 µg/kg/h and 0.7 µg/kg/h was effective and safe for the resection of cataract patients in North Central Hospital of PEMEX, it had a good control of the respiratory rate, heart rate and mean arterial pressure.

REFERENCES

1. Castellanos-Olivares, Vásquez-Márquez I. La evaluación preanestésica en el paciente geriátrico. Rev Mex Anest. 2011;34:S174-S179.

2. Gross JB, Bailey PL, Caplan RA. Practice guidelines for sedation and analgesia by non-anesthesiologists: A report by the American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Anesthesiology. 1996;84:459-471.

3. Ramsay MA. Controlled Sedation with Alphaxalone-Alphadolone. BMJ. 1974;2:656-659.

4. Panzer O, et al. Pharmacology of Sedative-Analgesic Agents: dexmedetomidine, remifentanil, ketamine, volatile anesthetics, and the role of peripheral mu antagonists. Critical Care Clin. 2009;25:451-469.

5. Reguera Espelet A. Estado actual del manejo perioperatorio del paciente geriátrico. En: Conferencia presentada en el I Congreso Virtual Mexicano de Anestesiología. Hospital Universitario de la Princesa Universidad Autónoma de Madrid; 2001.

6. Alhashemi JA. Dexmedetomidine vs. midazolam for monitored anaesthesia care during cataract surgery. B J Anaesth. 2006;6:722-726.

7. Rebecca Y, et al. Hemodynamic impact of dexmedetomidine administration in 15,656 noncardiac surgical cases. J Clin Anesth. 2012;24:212-220.

8. Michael A, et al. Hemodynamic characteristics of midazolam, propofol, and dexmedetomidine in healthy volunteers. J Clin Anesth. 2011;23:218-223.

9. A. Apan, et al. Bispectral index-guided intraoperative sedation with dexmedetomidine and midazolam infusion in outpatient cataract surgery. Minerva Anestesiol. 2009;75:239-244.