Comparing the Effects of Oral Clonidine Premedication With Intraoperative Dexmedetomidine Infusion on Anesthetic Requirement and Recovery From Anesthesia in Patients Undergoing Major Spine Surgery
Notice bibliographique
Résumé
BACKGROUND: Clonidine, an α2 agonist, has been used in anesthesia for many years to provide sedation, anxiolysis, analgesia, controlled hypotension, and to provide opioid-sparing anesthesia. Recently, there has been a great interest in using the newer α2 agonist, dexmedetomidine, because of its more selectivity toward α2 adrenoreceptors. We compared the effects of clonidine with dexmedetomidine on anesthetic requirement and recovery from anesthesia. METHODS: Seventy-four patients undergoing major spine surgery were randomly allocated to receive either oral clonidine premedication followed by an intraoperative saline infusion (group A) or placebo premedication followed by dexmedetomidine infusion in the intraoperative period (group B). Standard anesthesia protocols were followed for induction and maintenance. Heart rate, blood pressure, and end-tidal concentrations of isoflurane were noted every 15 minutes after proning. Hypertensive responses were treated with bolus doses of propofol and fentanyl. Hypotensive episodes were treated with bolus doses of ephedrine or phenylephrine. Primary outcomes were the comparisons of the effect of these 2 drugs on anesthetic requirement and recovery from anesthesia. Secondary outcomes were the comparisons of the hemodynamic response, intraoperative analgesic requirement, and blood loss during surgery. RESULTS: Demographic data, duration of surgery, total dose of fentanyl and propofol requirement, blood loss, and the recovery time were comparable between the 2 groups. Both drugs reduced the isoflurane requirement during surgery. However, the reduction was more and statistically significant with dexmedetomidine compared with clonidine group at 1 and 2 hours after proning (P=0.001, 0.039 at 1 and 2 h). Both drugs are equally effective in controlling the hemodynamics, and the number of episodes of hypotension, hypertension, and bradycardia were comparable between the 2 groups. CONCLUSIONS: Both clonidine and dexmedetomidine have anesthetic-sparing effect; however, it was more with dexmedetomidine than with clonidine. Recovery from isoflurane anesthesia was similar between both groups. Both are equally effective in controlling the hemodynamic response and reducing the blood loss during spine surgery.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».