Laparoscopic appendectomy under spinal anesthesia with dexmedetomidine infusion

Korean Journal of Anesthesiology 2014³â 67±Ç 4È£ p.246 ~ p.251

Àü°í¿î(Jun Go-Woon) - Konyang University College of Medicine Konyang University Hospital Department of Anesthesiology and Pain Medicine
±è¹Î¼ö(Kim Min-Su) - Konyang University College of Medicine Konyang University Hospital Department of Anesthesiology and Pain Medicine
¾çÇåÁÖ(Yang Hun-Ju) - Konyang University College of Medicine Konyang University Hospital Department of Anesthesiology and Pain Medicine
¼ºÅÂÀ±(Sung Tae-Yun) - Konyang University College of Medicine Konyang University Hospital Department of Anesthesiology and Pain Medicine
¹Úµ¿È£(Park Dong-Ho) - Konyang University College of Medicine Konyang University Hospital Department of Anesthesiology and Pain Medicine
Á¶Ãá±Ô(Cho Choon-Kyu) - Konyang University College of Medicine Konyang University Hospital Department of Anesthesiology and Pain Medicine
±ÇÈñ¿í(Kwon Hee-Uk) - Konyang University College of Medicine Konyang University Hospital Department of Anesthesiology and Pain Medicine
°­Æ÷¼ø(Kang Po-Soon) - Konyang University College of Medicine Konyang University Hospital Department of Anesthesiology and Pain Medicine
¹®ÁÖÀÍ(Moon Ju-Ik) - Konyang University College of Medicine Konyang University Hospital Department of Surgery

Abstract

Background: Laparoscopic appendectomy (LA) is rarely performed under regional anesthesia because of pneumoperitoneum-related problems. We expected that dexmedetomidine would compensate for the problems arising from spinal anesthesia alone. Thus, we performed a feasibility study of spinal anesthesia with intravenous dexmedetomidine infusion.

Methods: Twenty-six patients undergoing LA received spinal anesthesia with intravenous dexmedetomidine infusion. During surgery, the patient¡¯s pain or discomfort was controlled by supplemental fentanyl or ketamine injection, and all adverse effects were evaluated.

Results: No patient required conversion to general anesthesia, and all operations were completed laparoscopically without conversion to open surgery. Seventeen (65.4%) patients required supplemental injection of fentanyl or ketamine. Bradycardia occurred in seven (26.9%) patients.

Conclusions: Spinal anesthesia with dexmedetomidine infusion may be feasible for LA. However, additional analgesia, sedation, and careful attention to the potential development of bradycardia are needed for a successful anesthetic outcome.

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Dexmedetomidine, Laparoscopic appendectomy, Spinal anesthesia
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