Ceballos CM, Osorio RG

Language: Spanish
References: 17
Page: 114-121
PDF size: 149.77 Kb.

ABSTRACT

Introduction. Obesity has become a common disease and bariatric surgery represents an opportunity for those with a degree of extreme obesity. A drug dexmedetomidine alpha 2 agonist with specificity alfa1/alfa2 is increasingly being used as medication transanestésica bariatric surgery in these patients.
Objective. Comparison of anesthetic effects in patients undergoing bariatric surgery in the central military hospital management more dexmedetomidine with fentanyl as an adjuvant to fentanyl.
Material and methods. We conducted a controlled clinical trial, experimental, comparative, longitudinal prospective randomized, studied 91 patients scheduled for bariatric surgery, divided into two groups, which underwent the same induction, speaking in Group 1, which is 1ìg/kg dexmedetomidine was administered to ideal weight, 250cc saline 0.9% to spend in 10 min. We measured hemodynamic transanestesicas, valuation at the time of emergence, at the time and 12 hours after the test, with the Ramsay scale and the Visual Analog Scale assessment graded numericallyforpain.
Results. The 2 groups on 1 comprised 45 patients and Group 2 of 46 patients, in which we find that the vital signs at any time of transanestesico, changes were greater than 20%, in the heart of the two groups statistically significant difference at p = 0.03, and mean arterial pressure in a p = 0.000. Comparing the consumption of fentanyl in both groups was p = 0.007 was lower in group 1. While the assessment of postoperative pain in the first hour and 12 hours there was noclinicallyorstatisticallysignificant.

REFERENCES

1. Antaa R, Kanto J, Scheinin M. Dexmedetomidine, an alpha2 adrenoceptor agonist, reduces anesthetic requirements for patients undergoing minor gynecologic surgery. Anesthesiology 1990; 73: 230-5.

2. Arroyo-Olvera EA, Cortés-Blanco BM. Consideraciones Anestésicas en cirugía Bariatrica, I.M.S.S. HGZ UMF #16 Torreón, Coahuila. México. México: Anestesia en México; p. 234-8.

3. Schmidt AP, et al. Effects of preanesthetic administration of midazolam, clonidine or dexmedetomidine on postoperative pain and anxiety in children. Paediatric Anesthesia 2007; 17: 667-74.

4. Prys-Roberts AC. Fentanyl a review. Clinic Anesthesiologist 1983; 1: 97-122.

5. Sinha AC. Some anesthetic aspects of morbid obesity University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. Current Opinion in Anaesthesiology 2009; 22: 442-6.

6. Ogunnaike BO, Jones SB, et al. Anesthetic Considerations for Bariatric Surgery, review article, Department of Anesthesiology and Pain Management, Southwestern Center for Minimally Invasive Surgery and Bariatric Program, University of Texas Southwestern Medical Center at Dallas, July 15, 2002, by the International Anesthesia Research Society.

7. Dominic SC. Dexmedetomidine: a review of clinical applications. Department of Anesthesiology. Ochsner Clinic Foundation. New Orleans, Louisiana, USA Correspondence, Staff Anesthesiologist, Department of Anesthesiology, Current Opinion in Anesthesiology 2008; 21: 457-46.

8. Cortes Blanco E. Boletín del Hospital infantil fórmula para ensayos clínicos controlados: Tamaño de muestra, una herramienta útil en las investigaciones pediátrica 1995; 52(6): 831-8.

9. James DF, et al. Fentanyl or Dexmedetomidine Combined With Desflurane for Bariatric. Department of Anesthesiology, University of Illinois at Chicago, Chicago. Surg J Clin Anesth 2006; 18: 24-8.

10. Servin F. Service d’Anesthe sie-Re´. Ambulatory anesthesia for the obese patient, Hospital Bichat. Paris, France. Current Opinion in Anaesthesiology 2006; 19: 597-9.

11. Marcel E. Durieux Anesthetic Dexmedetomidine Infusion During Laparoscopic Bariatric Surgery: The Effect on Recovery Outcome Variables From the Departments of Surgery, University of Texas Southwestern Medical Center at Dallas, International Anesthesia Research Society. February 8, 2008.

12. Samuels PJ. Anesthesia for Adolescent Bariatric Surgery, chapter 4, Copyright© Lippincott Williams & Wilkins. p. 17-33.

13. Peñuelas-Acuña J. Utilidad del índice biespectral (BIS) en la reducción del costo de fármacos para la anestesia. Vol. 7. Núm. 4. Servicio de Anestesiología, Fisiología y T. Respiratoria y Clínica del Dolor del Hospital Juárez de México, Derechos reservados. Academia Mexicana de Cirugía.

14. Salgado BA, Queiro VT. Efectividad y seguridad del balón intragástrico en pacientes obesos y con sobrepeso. Revisión sistemática y registro de casos. Madrid: Ministerio de Sanidad y Consumo. Avalia número 03, 2006.

15. Joseph T. Dexmedetomidine: Applications in pediatric critical care and pediatric anesthesiology From the Departments of Anesthesiology and Pediatrics. Vol. 8, No. 2. University of Missouri, Columbia, MO. Critical Care Federation of Pediatric Intensive and Critical Care Societies; 2007.

16. Tufanogullari PF. White, Dexmedetomidine Infusion During Laparoscopic Bariatric Surgery: The Effect on Recovery Outcome Variables Burcu Anesthesia and Analgesia, Departments of Anesthesiology and Pain Management, and Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, TX: 2009.

17. Zub D. Preliminary experience with oral dexmedetomidine for procedural and anesthetic premedication. Paediatric Anesthesia 2005; 15: 932-8.