caa a22 4500 445373660 CHVBK 20180317142955.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00540-011-1113-8 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1113-8 Dexmedetomidine: an alternative for epidural anesthesia in tension-free vaginal-tape surgery [Elektronische Daten] [Alparslan Turan, Hüseyin Şen, Ali Sızlan, Ömer Yanarateş, Sezai Özkan, Onur Koyuncu, Güner Dağli] Purpose: Anesthetic management of tension-free vaginal-tape (TVT) procedures is sometimes difficult to deal with, especially when surgeons request a cough test. Dexmedetomidine has unique sedative and analgesic properties while having minimal respiratory effects, making it suitable for perioperative use in monitored anesthesia care. We aimed to compare dexmedetomidine and epidural anesthesia in TVT patients. Methods: Forty-nine women [American Society of Anesthesiologists (ASA 1-3)] with genuine stress incontinence confirmed by preoperative bladder function studies were included in this double-blind, randomized study. The patients were randomly assigned to one of two groups: group D received 0.5μg/kg dexmedetomidine IV applied as bolus over 10min and continued with 0.5μg/kg/h infusion, and local anesthesia (lidocaine 2% with epinephrine) performed by the surgeon. Group E received epidural anesthesia with 15ml of 0.25% bupivacaine+100μg fentanyl. Patients were monitored every 5min for mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation, respiratory rate, sedation, and intraoperative and postoperative pain. Ability to cough was also evaluated by the surgeon. Results: There was no difference in ability to cough, and this was evaluated by the surgeon as adequate, and there was no difference in scores between groups. Significant decreases in MAP and HR were observed 10min after the start of surgery in group D compared with group E, and they were significantly decreased until first and second postoperative hours, respectively (p<0.05). None of the patients had respiratory rate decrease or apnea. Side effects encountered postoperatively were similar. Conclusion: Dexmedetomidine can be an alternative to epidural anesthesia in TVT procedure requiring cough test. Japanese Society of Anesthesiologists, 2011 Dexmedetomidine nationallicence Epidural nationallicence Tension-free vaginal tape nationallicence Turan Alparslan The Cleveland Clinic, 9500 Euclid Avenue, P-77, Department of Outcomes Research, Anesthesiology Institute, 44195, Cleveland, OH, USA aut Şen Hüseyin Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy Haydarpasa Training Hospital Üsküdar, Istanbul, Turkey aut Sızlan Ali Department of Anesthesia and Reanimation, Gülhane Military Medical Academy, Ankara, Turkey aut Yanarateş Ömer Department of Anesthesia and Reanimation, Gülhane Military Medical Academy, Ankara, Turkey aut Özkan Sezai Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy Haydarpasa Training Hospital Üsküdar, Istanbul, Turkey aut Koyuncu Onur Department of Anesthesiology, Trakya University, Edirne, Turkey aut Dağli Güner Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy Haydarpasa Training Hospital Üsküdar, Istanbul, Turkey aut Journal of Anesthesia Springer Japan 25/3(2011-06-01), 386-391 0913-8668 25:3<386 2011 25 540 https://doi.org/10.1007/s00540-011-1113-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1113-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Turan Alparslan The Cleveland Clinic, 9500 Euclid Avenue, P-77, Department of Outcomes Research, Anesthesiology Institute, 44195, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Şen Hüseyin Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy Haydarpasa Training Hospital Üsküdar, Istanbul, Turkey aut NATIONALLICENCE 700 1- Sızlan Ali Department of Anesthesia and Reanimation, Gülhane Military Medical Academy, Ankara, Turkey aut NATIONALLICENCE 700 1- Yanarateş Ömer Department of Anesthesia and Reanimation, Gülhane Military Medical Academy, Ankara, Turkey aut NATIONALLICENCE 700 1- Özkan Sezai Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy Haydarpasa Training Hospital Üsküdar, Istanbul, Turkey aut NATIONALLICENCE 700 1- Koyuncu Onur Department of Anesthesiology, Trakya University, Edirne, Turkey aut NATIONALLICENCE 700 1- Dağli Güner Department of Anesthesiology and Reanimation, Gülhane Military Medical Academy Haydarpasa Training Hospital Üsküdar, Istanbul, Turkey aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/3(2011-06-01), 386-391 0913-8668 25:3<386 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer