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The effect of dexmedetomidine pretreatment on the median effective bolus dose of propofol for facilitating laryngeal mask airway insertion

Yoo, JY  | Kwak, HJ | Kim, YB | Park, CK | Lee, SY  | Kim, JY
Journal of anesthesia, 31(1). : 11-17, 2017
Journal Title
Journal of anesthesia
BACKGROUND: We designed this study to investigate the effect of dexmedetomidine (1 mug/kg) pretreatment on the median effective dose (ED50) of propofol for facilitating successful laryngeal mask airway (LMA) insertion compared to propofol alone.
METHODS: Forty patients were randomized to either the control group (n = 21) or the dexmedetomidine group (n = 19). After infusion of normal saline or dexmedetomidine 1 microg/kg over 10 min, 1 % lidocaine 0.5 mg/kg, followed by propofol 2.5 mg/kg was administered and the laryngeal mask airway was inserted without muscle relaxants. The ED50 of propofol for successful LMA insertion was determined by the modified Dixon's up-and-down method. The ED50 and ED95 were also calculated using an isotonic regression method, based on the pooled adjacent-violators algorithm-adjusted response rate, and the confidential interval (CI) was estimated using a bootstrap approach.
RESULTS: The ED50 of propofol for smooth insertion of the LMA was significantly higher in the control group than in the dexmedetomidine group (3.1 +/- 0.4 vs 1.9 +/- 0.3 mg/kg, P < 0.001). From isotonic regression analysis using a bootstrap approach, the ED50 and ED95 of propofol was 2.9 mg/kg (83 % CI 2.5-3.3 mg/kg) and 3.9 mg/kg (95 % CI 3.5-4.0 mg/kg) in the control group, and 1.8 mg/kg (83 % CI 1.8-2.1 mg/kg) and 2.4 mg/kg (95 % CI 2.0-2.5 mg/kg) in the dexmedetomidine groups, respectively. The apnea time was not significantly different between the two groups.
CONCLUSIONS: Pretreatment with dexmedetomidine 1 mug/kg could reduce the propofol requirement by 38 % for facilitating LMA insertion without prolonged respiratory depression and hemodynamic instability.

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Journal Papers > School of Medicine / Graduate School of Medicine > Anesthesiology & Pain Medicine
Ajou Authors
김, 종엽  |  유, 지영  |  이, 숙영
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