Intravenous dexmedetomidine infusion in adult patients undergoing open nephrolithotomy: Effects on intraoperative hemodynamics and blood loss; a randomized controlled trial

摘要

Objective The aim of this study was to evaluate the effect of intravenous infusion of dexmedetomidine on intraoperative hemodynamics and blood loss during open nephrolithotomy under general anesthesia in adult patients. Method 50 male and female patients, ASA physical status I and II aged 20–60 years old scheduled for open nephrolithotomy under general anesthesia were randomly allocated into two equal groups: Group D ( n = 25): received a bolus dose of IV dexmedetomidine. 1 μg/kg over 10 min before induction of anesthesia and then IV infusion of 0.1–0.5 μg/kg/h guided by the hemodynamics. Group P ( n = 25): received a bolus dose of 10 ml Ringer lactate solution before induction of anesthesia, and infusion was continued during surgery. General anesthesia was induced in all patients using fentanyl, propofol and atracurium. The following parameters were recorded: heart rate and systolic and diastolic arterial blood pressure: before and after induction of anesthesia and then every 15 min intraoperatively, volume of blood loss (ml), laboratory hemoglobin % and hematocrit concentration: preoperative, intraoperative and immediate postoperative and number of the transfused units of PRBCs. Results Intraoperative heart rate and systolic and diastolic arterial blood pressure were statistically significantly lower in group D than in group P. The intraoperative blood volume lost was statistically significantly higher in group P than in group D. A number of the transfused units of PRBCs, intraoperative and postoperative hemoglobin % and hematocrit concentration were statistically significantly lower in group P than in group D. Conclusion Dexmedetomidine infusion in patients undergoing open nephrolithotomy under general anesthesia was associated with intraoperative hemodynamic stability, which decreases intraoperative blood loss and the need for intraoperative blood transfusion.