caa a22 4500 445373318 CHVBK 20180317142954.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00540-011-1215-3 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1215-3 Dexmedetomidine can stabilize hemodynamics and spare anesthetics before cardiopulmonary bypass [Elektronische Daten] [Takayuki Kunisawa, Megumi Ueno, Atsushi Kurosawa, Michio Nagashima, Dai Hayashi, Tomoki Sasakawa, Akihiro Suzuki, Osamu Takahata, Hiroshi Iwasaki] Purpose: We previously confirmed the effectiveness of dexmedetomidine (DEX) for stabilizing hemodynamics as well as sparing anesthetics during anesthetic induction in patients undergoing cardiac surgery (Kunisawa et al. in J Clin Anesth 21:194-199, 1). In this study, we investigated whether these effects of DEX continue until the start of cardiopulmonary bypass (CPB). Methods: Twenty-two patients with mild to moderate cardiovascular disease were randomized into two groups [DF2 group: DEX dose of 0.7μg/kg/h after initial dose and effect-site concentration (ESC) of fentanyl of 2ng/ml; PF4 group: saline and ESC of fentanyl of 4ng/ml]. Propofol was administered for anesthetic induction and maintenance. Hemodynamics, cardiovascular drugs, ESC of propofol, and cardiovascular responses to skin incision (SI) and sternotomy (St) were measured or calculated. Results: Blood pressure (BP) at the pre-/post-SI periods was higher in the DEX group (137±17/140±16mmHg) than in the placebo group (85±9/109±24mmHg). Percent increases in cardiovascular response to SI or St were lower in the DEX group than in the placebo group (for example, 1.9±2.2 vs. 27.4±19.9% in systolic BP due to SI). ESCs of propofol at SI and St in the DEX group were lower than those in the placebo group. Conclusions: DEX combined with 2ng/ml fentanyl before CPB can suppress the decrease in blood pressure at the pre- and post-SI periods, can blunt the cardiovascular responses to SI and St, and can spare the required ESC of propofol despite fentanyl concentration, which was half of that in the placebo group. Japanese Society of Anesthesiologists, 2011 Dexmedetomidine nationallicence Anesthetic-sparing effect nationallicence Adjuvant nationallicence Before cardiopulmonary bypass nationallicence Kunisawa Takayuki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut Ueno Megumi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut Kurosawa Atsushi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut Nagashima Michio Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut Hayashi Dai Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut Sasakawa Tomoki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut Suzuki Akihiro Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut Takahata Osamu Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut Iwasaki Hiroshi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut Journal of Anesthesia Springer Japan 25/6(2011-12-01), 818-822 0913-8668 25:6<818 2011 25 540 https://doi.org/10.1007/s00540-011-1215-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1215-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kunisawa Takayuki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Ueno Megumi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Kurosawa Atsushi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Nagashima Michio Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Hayashi Dai Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Sasakawa Tomoki Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Suzuki Akihiro Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Takahata Osamu Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 700 1- Iwasaki Hiroshi Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College, 2-1-1-1 Midorigaoka-higashi, 0788510, Asahikawa, Hokkaido, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/6(2011-12-01), 818-822 0913-8668 25:6<818 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer