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Peri-operative use of dexmedetomidine in airway reconstruction surgery for obstructive sleep apnoea

Published online by Cambridge University Press:  26 October 2009

S Chawla ,
S Robinson ,
A Norton ,
A Esterman  and
T Taneerananon
S Chawla*
Affiliation:
Department of ENT, Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia
S Robinson
Affiliation:
Department of ENT, Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia
A Norton
Affiliation:
Department of Anaesthesia, Flinders Medical Centre, Adelaide, Australia
A Esterman
Affiliation:
Division of Health Sciences, University of South Australia, Adelaide, South Australia
T Taneerananon
Affiliation:
Department of surgery, Canberra Hospital, Australian Capital Territory, Australia
*
Address for correspondence: Dr Sharad Chawla, ENT Department, Flinders Medical Centre, Bedford Park, Adelaide, SA, Australia5042. Fax: +61 8 83744928 E-mail: sharadch@yahoo.com
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Abstract

Objective:

To evaluate the peri-operative usefulness of dexmedetomidine in obstructive sleep apnoea surgery.

Methods:

In a clinical audit, patients were divided into a study group (dexmedetomidine used; n = 125; 82.9 per cent males, 17.1 per cent females; mean age 48.1 years) and a control group (dexmedetomidine not used; n = 143; 85.5 per cent males, 14.5 per cent females; mean age 47.4 years). The selected outcome measures were mean arterial pressure, use of anti-hypertensives and use of opioids.

Results:

Mean arterial pressure was stable (i.e. below 100 mmHg) in 93.3 per cent of the study group and 72.0 per cent of the control group (relative risk 1.30, 95 per cent confidence interval 1.14–1.47). The use of glyceryl trinitrate and hydralazine was significantly less in the study group, compared with controls (p = 0.005 and <0.001, respectively). Study group patients underwent more procedures than control patients (p < 0.001) and were more likely to require morphine. No difference was noted in the median dose of opioids.

Conclusion:

Dexmedetomidine improves haemodynamic stability in patients undergoing surgery for obstructive sleep apnoea. It is reliable and reduces the need for polypharmacy. Its opioid-sparing action has been established in the literature; however, this was not demonstrated in our study.

Keywords

Sleep Apnea SyndromesDexmedetomidineAnesthesia
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 1 , January 2010 , pp. 67 - 72
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the 57th Annual Scientific Meeting of the Australian Society of Otolaryngology Head and Neck Surgery, 1st April 2007, Adelaide, South Australia, Australia.

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