The Effects of Intramuscular Dexmedetomidine Premedication on Hemodynamics, Plasma Norepinephrine, Cortisol and Glucose Concentrations

Abstract

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 N <inf>2</inf>O 66% in O <inf>2</inf>. Electrocardiogram, pulse oxymeter and noninvasive blood pressure were monitored. Patients were divided into two groups: Group D patients received 1 μg kg-1 dexmedetomidine in saline (total volume 3 ml) in the deltoid muscle. Dexmedetomidine premedication 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 μg 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.