Journal of Yeungnam Medical Science

Original article

Anesthesiology and Pain Medicine
Effect of intrathecal fentanyl on dexmedetomidine requirement for sedation during spinal anesthesia: a randomized controlled trial: Ki Beom Park, Ji-Yong Yeom, Juhee Min, Hyeon Seung Yi, Gaeul Hur, Eun Kyung Choi; J Yeungnam Med Sci. 2026;43:47. Published online July 9, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.47

430 View
57 Download

Abstract PDF: Background
Adequate sedation during spinal anesthesia requires careful titration to avoid hemodynamic instability and respiratory complications. We hypothesized that intrathecal fentanyl, used as an adjunct to neuraxial anesthesia, would reduce dexmedetomidine requirements for conscious sedation. This study evaluated the effects of intrathecal fentanyl on the total dose of dexmedetomidine during spinal anesthesia.
Methods
Sixty-four patients undergoing knee or ankle arthroscopy under spinal anesthesia were randomly assigned to two groups. The fentanyl group received 0.5% bupivacaine 10 mg with fentanyl 20 μg, whereas the control group received bupivacaine 10 mg with saline. After confirmation of sensory block, dexmedetomidine was infused at 1 μg/kg over 10 minutes and maintained at 0.1–1 μg/kg/hour to maintain a bispectral index (BIS) of 70 to 80. The primary outcome was the total dose of dexmedetomidine. Secondary outcomes included BIS values, Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) scores, mean blood pressure, and heart rate at predefined time points.
Results
The total dose of dexmedetomidine did not differ significantly between the groups. The MOAA/S scores were significantly affected by group, time, and group-by-time interactions (p=0.003, p<0.001, and p=0.007, respectively). The BIS values were influenced by group (p=0.026) and time (p<0.001), but not by group-by-time interactions (p=0.413). Exploratory analyses suggested deeper sedation in the fentanyl group during the early phase of dexmedetomidine infusion. Hemodynamic variables were comparable between the groups.
Conclusion
Intrathecal fentanyl did not significantly reduce dexmedetomidine requirements during spinal anesthesia, although it was associated with deeper sedation at several time points.

Original Article

Anesthesiology and Pain Medicine
Ultrasound-guided superficial cervical plexus block under dexmedetomidine sedation versus general anesthesia for carotid endarterectomy: a retrospective pilot study: Wangseok Do, Ah-Reum Cho, Eun-Jung Kim, Hyae-Jin Kim, Eunsoo Kim, Heon-Jeong Lee; Yeungnam Univ J Med. 2018;35(1):45-53. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.45

10,931 View
95 Download
9 Crossref

Background
Carotid endarterectomy (CEA) has been performed under regional and general anesthesia (GA). The general anesthesia versus local anesthesia for carotid surgery study compared the two techniques and concluded that there was no difference in perioperative outcomes. However, since this trial, new sedative agents have been introduced and devices that improve the delivery of regional anesthesia (RA) have been developed. The primary purpose of this pilot study was to compare intraoperative hemodynamic stability and postoperative outcomes between GA and ultrasound-guided superficial cervical plexus block (UGSCPB) under dexmedetomidine sedation for CEA.
Methods
Medical records from 43 adult patients who underwent CEA were retrospectively reviewed, including 16 in the GA group and 27 in the RA group. GA was induced with propofol and maintained with sevoflurane. The UGSCPB was performed with ropivacaine under dexmedetomidine sedation. We compared the intraoperative requirement for vasoactive drugs, postoperative complications, pain scores using the numerical rating scale, and the duration of hospital stay.
Results
There was no difference between groups in the use of intraoperative antihypertensive drugs. However, intraoperative inotropic and vasopressor agents were more frequently required in the GA group (p<0.0001). In the GA group, pain scores were significantly higher during the first 24 h after surgery (p<0.0001 between 0-6 h, p<0.004 between 6-12 h, and p<0.001 between 12-24 h). The duration of hospital stay was significantly more in the GA group (13.3±4.6 days in the GA group vs. 8.5±2.4 days in the RA group, p<0.001).
Conclusion
In this pilot study, intraoperative hemodynamic stability and postoperative outcomes were better in the RA compared to the GA group.

Citations

Citations to this article as recorded by

Dexmedetomidine during carotid endarterectomy: a registry on safety and satisfaction of patients and operators (DexTEA)
Diego FIUME, Elisa DE CAROLIS, Michele ARCIUOLO, Giulia LICIANI, Silvia CARLINI, Roberto POLIDORO, Paola PICERNO, Pasquale AVELLA, Stefano BARTOLI, Mario PEVERINI, Massimo GALLETTI
Minerva Surgery.2026;[Epub] CrossRef
Evaluating Anesthesia Guidance for Rescue Analgesia in Awake Patients Undergoing Carotid Endarterectomy with Cervical Plexus Blocks: Preliminary Findings from a Randomized Controlled Trial
Michał Jan Stasiowski, Nikola Zmarzły, Beniamin Oskar Grabarek
Journal of Clinical Medicine.2024; 14(1): 120. CrossRef
Outcomes of Dexmedetomidine with Local Regional Anesthesia in Carotid Endarterectomy
Samik H. Patel, Vikram L. Sundararaghavan, Amber M. Pawlikowski, Jeremy Albright, Jason M. Adams, Michael J. Heidenreich, Robert J. Beaulieu, Abdulhameed Aziz
Annals of Vascular Surgery.2023; 89: 174. CrossRef
Anesthetic Management of a Patient Undergoing Cochlear Implantation With Superficial Cervical Plexus Block and Sedation: A Case Report
Natsuki Takemura, Tetsuya Miyashita, Yasuko Baba
A&A Practice.2022; 16(1): e01555. CrossRef
Ultrasound-guided intermediate cervical plexus block for postoperative analgesia in patients undergoing carotid endarterectomy under general anesthesia: a case-control study
Onat BERMEDE, Volkan BAYTAŞ
Journal of Contemporary Medicine.2022; 12(2): 261. CrossRef
Relationship between annular calcification of plaques in the carotid sinus and perioperative hemodynamic disorder in carotid angioplasty and stenting
Qingjie Chi, Zhuo Chen, Li Zhu, Ruifan Yuan, Kaixuan Ren, Tianle Wang, Wenbin Ding
Journal of Stroke and Cerebrovascular Diseases.2022; 31(10): 106634. CrossRef
Cardiac output and cerebral blood flow during carotid surgery in regional versus general anesthesia: A prospective randomized controlled study
Helmuth Tauber, Werner Streif, Jennifer Gebetsberger, Lukas Gasteiger, Eve Pierer, Michael Knoflach, Gustav Fraedrich, Maria Gummerer, Josef Fritz, Corinna Velik-Salchner
Journal of Vascular Surgery.2021; 74(3): 930. CrossRef
Cerebral and Systemic Stress Parameters in Correlation with Jugulo-Arterial CO2 Gap as a Marker of Cerebral Perfusion during Carotid Endarterectomy
Zoltán Kovács-Ábrahám, Timea Aczél, Gábor Jancsó, Zoltán Horváth-Szalai, Lajos Nagy, Ildikó Tóth, Bálint Nagy, Tihamér Molnár, Péter Szabó
Journal of Clinical Medicine.2021; 10(23): 5479. CrossRef
Plexus anesthesia versus general anesthesia in patients for carotid endarterectomy with patch angioplasty: Protocol for a systematic review with meta-analyses and Trial Sequential Analysis of randomized clinical trials
M. S. Marsman, J. Wetterslev, F. Keus, D. van Aalst, F. G. van Rooij, J. M.M. Heyligers, F. L. Moll, A. Kh. Jahrome, P. W.H.E Vriens, G. G. Koning
International Journal of Surgery Protocols.2020; 19: 1. CrossRef

First
Prev
Page of 1
Next
Last

Search