STUDY OBJECTIVE: To evaluate the effects of dexmedetomidine, an alpha-2 agonist, as an intravenous sedative drug and the effects of atipamezole, an alpha-2 antagonist, on recovery. DESIGN: Randomized, double-blind study with three parallel groups. An open dose-finding study preceded it to optimize the atipamezole dose. SETTING:Outpatient operating room at the gynecologic and obstetric university hospital in Helsinki, Finland. PATIENTS: Seventy-two healthy women scheduled for legal termination of pregnancy. INTERVENTIONS: Patients were assigned to one of three groups of 24 patients each to receive either dexmedetomidine 2 micrograms/kg and atipamezole 50 micrograms/kg; dexmetomidine 2 micrograms/kg and saline; or midazolam 0.15 mg/kg and saline. In addition to paracervical block, each patient received two different study drugs: study drug 1 was a sedative agent (either dexmedetomidine or midazolam), administered before the procedure. If the sedation was not deep enough and the patient reacted to the procedure, a low dose of propofol was administered. Study drug 2 was a reversing agent or a placebo, administered following the procedure. MEASUREMENTS AND MAIN RESULTS: The mean time to regain consciousness was shorter in the dexmedetomidine-atipamezole and the dexmedetomidine-saline groups compared with the midazolam group. Postoperative sedation, tested both by subjective and objective assessments, decreased more quickly in the dexmedetomidine-atipamezole group compared with the dexmedetomidine-saline and the midazolam groups. CONCLUSION:Atipamezole is an effective antagonist for reversing psychomotor impairment following dexmedetomidine sedation.
RCT Entities:
STUDY OBJECTIVE: To evaluate the effects of dexmedetomidine, an alpha-2 agonist, as an intravenous sedative drug and the effects of atipamezole, an alpha-2 antagonist, on recovery. DESIGN: Randomized, double-blind study with three parallel groups. An open dose-finding study preceded it to optimize the atipamezole dose. SETTING:Outpatient operating room at the gynecologic and obstetric university hospital in Helsinki, Finland. PATIENTS: Seventy-two healthy women scheduled for legal termination of pregnancy. INTERVENTIONS:Patients were assigned to one of three groups of 24 patients each to receive either dexmedetomidine 2 micrograms/kg and atipamezole 50 micrograms/kg; dexmetomidine 2 micrograms/kg and saline; or midazolam 0.15 mg/kg and saline. In addition to paracervical block, each patient received two different study drugs: study drug 1 was a sedative agent (either dexmedetomidine or midazolam), administered before the procedure. If the sedation was not deep enough and the patient reacted to the procedure, a low dose of propofol was administered. Study drug 2 was a reversing agent or a placebo, administered following the procedure. MEASUREMENTS AND MAIN RESULTS: The mean time to regain consciousness was shorter in the dexmedetomidine-atipamezole and the dexmedetomidine-saline groups compared with the midazolam group. Postoperative sedation, tested both by subjective and objective assessments, decreased more quickly in the dexmedetomidine-atipamezole group compared with the dexmedetomidine-saline and the midazolam groups. CONCLUSION:Atipamezole is an effective antagonist for reversing psychomotor impairment following dexmedetomidine sedation.
Authors: Lenneke Schrier; Rob Zuiker; Frans W H M Merkus; Erica S Klaassen; Zheng Guan; Bert Tuk; Joop M A van Gerven; Ronald van der Geest; Geert Jan Groeneveld Journal: Br J Clin Pharmacol Date: 2016-12-20 Impact factor: 4.335
Authors: Samuel R Chamberlain; Ulrich Müller; Andrew D Blackwell; Trevor W Robbins; Barbara J Sahakian Journal: Psychopharmacology (Berl) Date: 2006-04-27 Impact factor: 4.530
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Authors: Hilary S McCarren; Julia A Arbutus; Cherish Ardinger; Emily N Dunn; Cecelia E Jackson; John H McDonough Journal: Epilepsy Res Date: 2018-01-31 Impact factor: 3.045