Takashin Nakayama1, Kiyotaka Uchiyama2, Kohkichi Morimoto3, Naoki Washida1,4, Takahiro Kasai4, Ran Nakamichi1, Ei Kusahana1, Shu Wakino1, Hiroshi Itoh1. 1. Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. 2. Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. kiyo.0817.piyo@gmail.com. 3. Apheresis and Dialysis Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan. 4. Department of Nephrology, International University of Health and Welfare School of Medicine, 4-3 Kozunomori, Narita, Chiba, Japan.
Abstract
PURPOSE: Dexmedetomidine (DEX) is a sedative agent with minimal respiratory and hemodynamic effects. The present study aimed to evaluate its effectiveness in peritoneal dialysis (PD) catheter insertion. METHODS: This single-center retrospective study included patients who underwent PD catheter insertion under spinal anesthesia in our hospital between January 2016 and December 2020. Patients were divided into the DEX and non-DEX groups according the use of DEX. After 1:1 propensity score matching to adjust for age, sex, body mass index, mean blood pressure (BP), and Charlson comorbidity index, we compared operation-related outcomes, including peak numerical rating scale (NRS), occurrence of nausea, vital signs, or operative time between the two groups. RESULTS: Of a total of 44 patients, 9 patients received DEX, and 35 did not. After propensity score matching, each group consisted of 8 patients. Peak NRS was significantly lower (P = 0.003) in the DEX group compared with the non-DEX group. Maximum mean BP during the operation was also significantly lower in the DEX group compared with the non-DEX group (P = 0.020), with no significant differences in minimum mean BP between the two groups (P = 0.831). The DEX group showed a trend of shortened operative time (P = 0.068). There were no significant differences in the occurrence of nausea (P = 1.000). Moreover, there was no clinically important adverse event associated with use of DEX. CONCLUSION: The use of DEX in PD catheter insertion under spinal anesthesia could safely improve operative analgesia.
PURPOSE: Dexmedetomidine (DEX) is a sedative agent with minimal respiratory and hemodynamic effects. The present study aimed to evaluate its effectiveness in peritoneal dialysis (PD) catheter insertion. METHODS: This single-center retrospective study included patients who underwent PD catheter insertion under spinal anesthesia in our hospital between January 2016 and December 2020. Patients were divided into the DEX and non-DEX groups according the use of DEX. After 1:1 propensity score matching to adjust for age, sex, body mass index, mean blood pressure (BP), and Charlson comorbidity index, we compared operation-related outcomes, including peak numerical rating scale (NRS), occurrence of nausea, vital signs, or operative time between the two groups. RESULTS: Of a total of 44 patients, 9 patients received DEX, and 35 did not. After propensity score matching, each group consisted of 8 patients. Peak NRS was significantly lower (P = 0.003) in the DEX group compared with the non-DEX group. Maximum mean BP during the operation was also significantly lower in the DEX group compared with the non-DEX group (P = 0.020), with no significant differences in minimum mean BP between the two groups (P = 0.831). The DEX group showed a trend of shortened operative time (P = 0.068). There were no significant differences in the occurrence of nausea (P = 1.000). Moreover, there was no clinically important adverse event associated with use of DEX. CONCLUSION: The use of DEX in PD catheter insertion under spinal anesthesia could safely improve operative analgesia.
Authors: Jorinde H H van Laanen; Tom Cornelis; Barend M Mees; Elisabeth J Litjens; Magda M van Loon; Jan H M Tordoir; Arnoud G Peppelenbosch Journal: Perit Dial Int Date: 2018-01-31 Impact factor: 1.756
Authors: Maud A S Weerink; Michel M R F Struys; Laura N Hannivoort; Clemens R M Barends; Anthony R Absalom; Pieter Colin Journal: Clin Pharmacokinet Date: 2017-08 Impact factor: 6.447