The Efficacy of Dexmedetomedine as an Indicator for Intravascular Epidural Catheter in Adult During General Anesthesia
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- Category: Vol. 82, December 2014
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The Efficacy of Dexmedetomedine as an Indicator for Intravascular Epidural Catheter in Adult During General Anesthesia, HOSSAM M. ATEF
Abstract
Background: No perfect method exists for identifying intravascular catheters all methods described in the literature have incidence of false positive and false negative results.
Aim: To evaluate the efficacy of dexmedetomedine as an Indicator for Intravascular Epidural Catheter in adult during General Anesthesia.
Methods: Forty patients scheduled for elective general surgery under propofol-fentanyl isoflurane anesthesia were randomized to receive either 3mL of lidocaine 15mg/mL with dexmedetomedine 1m/kg or 3mL of saline IV (n=20 each). HR, SBP, was monitored for 5min. after injection.
Results: After IV injection of the test dose, mean values of HR and SBP in the dexmedetomedine group were signifi-cantly lower than those in the saline group between 40-300 and 60-300s, respectively (p<0.05). Mean maximum decre-ments in HR and SBP in the dexmedetomedine group were 11.65±2.89bpm and 18.5±6.18mmHg and occurred at 140 and 240s after injection, respectively.
All patients in the dexmedetomedine group, and none in the saline group, developed HR decrease > to 10 bpm. There-fore, sensitivity, specificity, +PV, and –PV according to the HR criterion were all 100%. On the other hand, 18 patients in the dexmedetomedine group, and none in the saline group, exhibited SBP decrements > to 15mm Hg, resulting in 90% sensitivity, 100% Specificity, 90, 9% –PV and 100% +PV. Two patients missed using SBP criterion.
Conclusion: Dexmedetomedine is a reliable indicator for detection of an intravascular injection of epidural test dose in adult patients under propofol-fentanyl isoflurane anesthesia.