The Effects Of Intramuscular Dexmedetomidine Premedication On Hemodynamics, Plasma Norepinephrine, Cortisol And Glucose Consentrations

The aim of our study was to investigate the effect of dexmedetomidine premedication on hemodynamic parameters, plasma Cortisol, norepinephrine, glucose levels and requirements of opioid for induction and postoperative period. This study was randomized controlled trial and population consisted of 57 patients (ASA I- II, aged 20-55 years) undergoing elective abdominal surgery. General anesthesia was induced with thiopental and cis-atracurium. Patients subsequently received desflurane 3-5% with 66% in Electrocardiogram, pulse oxymeter and noninvasive blood pressure were monitored. Patients were divided into two groups: Group D patients received 1 ug kg-1 dexmedetomidine in saline (total volume 3 ml) in the deltoid muscle. Dexmedetomidine premed icatio n was not given to the control group. Plasma cortisol and norepinephrine levels were recorded 1 hour before induction, 1 and 30 min. after skin incision, 1 min after skin closure. In control group, heart rate (HR) and mean arterial pressure (MAP) increased after intubation and extubation when compared to baseline values. In dexmedetomidine group, HR and MAP were similar to baseline values. Plasma norepinephrine level increased in control group during surgery. However, plasma norepinephrine levels 1 and 30 min after skin incision decreased when compared to baseline values.We found that 1 ug kg-1 of intramuscular dexmedetomidine premedication reduced opioid requirement at induction and postoperative period without any changes in hemodynamic parameters, cortisol and glucose levels. We concluded that intramuscular dexmedetomidine premedication should be alternative to other premedicant agents. Intramuskuler Deksmedetomidin Premedikasyonunun Hemodinami, Plazma Kortizol, Norepinefrin ve Glukoz Konsantrasyonuna Etkisi Bu calismanin amaci; deksmedetomidin premedikasyonunun hemodinamik parametreler, plazma kortizol, norepinefrin, glukoz duzeyi ile induksiyon ve postoperatif donemdeki opioid ihtiyacina etkisini arastirmaktir. Elektif abdominal cerrahi operasyonu gecirecek yaslari 20-55 olan, ASA I-II grubu toplam 57 hasta calismaya alindi. Genel anestezi induksiyonunda tiyopental ve sisatrakuryum kullanildi. Anestezi idamesi N2O+O2+ %3-5 desfluran ile saglandi. EKG, noninvaziv kan basinci, pulsoksimetre monitorize edildi. Hastalar iki gruba ayrildi. Grup D'deki hastalara 1 ug kg-1 deksmedetomidin, toplam 3 ml salin icinde deltoid kas icine yapildi. Kontrol grubuna deksmedetomidin premedikasyonu verilmedi. Plazma kortizol ve norepinefrin (NE) duzeyleri induksiyondan 1 saat once, cilt insizyonundan 1 ve 30 dakika sonra ve cilt kapandiktan 1 dak. sonra olculdu. Kontrol grubunda; kalp atim hizi ve ortalama kan basinci preoperatif degerlere gore entu-basyon ve ekstubasyondan sonra yukseldi. Deksmedetomidin grubunda ise preoperatif degerlere benzerdi. Plazma norepinefrin duzeyi cerrahi suresince kontrol grubunda yuksekti. Fakat, plazma NE duzeyi insizyondan 1 ve 30 dak. sonra preoperatif degerlere gore dusuktu. Intramuskuler deksmedetomidin premedikasyonunun hemodinamik parametreler, kortizol ve glukoz duzeylerinde degisiklik yapmadan induksiyon ve postoperatif donemdeki opioid ihtiyacini azalttigini gosterdik. Intramuskuler deksmedetomidin premedikasyonunun diger premedikasyon ajanlarina alternatif olabilecegi kanisina vardik.