The hemodynamic and adrenergic effects of perioperative dexmedetomidine infusion after vascular surgery

UMMS Affiliation

Department of Anesthesiology; Department of Surgery

Publication Date


Document Type



Adrenergic alpha-Agonists; Adult; Aged; Aged, 80 and over; Blood Pressure; Catecholamines; Clonidine; Dexmedetomidine; Double-Blind Method; Female; Heart Rate; Humans; Male; Middle Aged; Vascular Surgical Procedures


Anesthesia and Analgesia | Anesthesiology | Heterocyclic Compounds | Surgical Procedures, Operative


We tested dexmedetomidine, an alpha(2) agonist that decreases heart rate, blood pressure, and plasma norepinephrine concentration, for its ability to attenuate stress responses during emergence from anesthesia after major vascular operations. Patients scheduled for vascular surgery received either dexmedetomidine (n = 22) or placebo (n = 19) IV beginning 20 min before the induction of anesthesia and continuing until 48 h after the end of surgery. All patients received standardized anesthesia. Heart rate and arterial blood pressure were kept within predetermined limits by varying anesthetic level and using vasoactive medications. Heart rate, arterial blood pressure, and inhaled anesthetic concentration were monitored continuously; additional measurements included plasma and urine catecholamines. During emergence from anesthesia, heart rate was slower with dexmedetomidine (73 +/- 11 bpm) than placebo (83 +/- 20 bpm) (P = 0.006), and the percentage of time the heart rate was within the predetermined hemodynamic limits was more frequent with dexmedetomidine (P < 0.05). Plasma norepinephrine levels increased only in the placebo group and were significantly lower for the dexmedetomidine group during the immediate postoperative period (P = 0.0002). We conclude that dexmedetomidine attenuates increases in heart rate and plasma norepinephrine concentrations during emergence from anesthesia.

IMPLICATIONS: The alpha(2) agonist, dexmedetomidine, attenuates increases in heart rate and plasma norepinephrine concentrations during emergence from anesthesia in vascular surgery patients.

DOI of Published Version



Anesth Analg. 2000 Apr;90(4):834-9.

Journal/Book/Conference Title

Anesthesia and analgesia

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Link to Article in PubMed

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