Protocolized Sedation With Dexmedetomidine In Percutaneous Nephrolithotomy: A Randomized, Controlled Clinical Trial

This study investigated the efficacy and safety of protocolized sedation with dexmedetomidine (Dex) in percutaneous nephrolithotomy (PCNL). Sixty patients with American Society of Anesthesiologists status I or II scheduled for PCNL under epidural anesthesia were randomly allocated to three groups. The patients in group D1 (n=20) received 0.5 mu g/kg Dex, those in group D2 (n=20) received 0.75 mu g/kg Dex, and those in the control group (n=20) received normal saline. The mean arterial pressure (MAP), heart rate, arterial oxygen saturation (SpO(2)), body temperature, and observer's assessment of alertness/sedation (OAA/S) scale score were recorded intraoperatively, and perioperative adverse reactions were also assessed. The MAP and SpO(2) did not significantly differ among the three groups (P>0.05). The heart rate was significantly lower in groups D1 and D2 than in the control group. Groups D1 and D2 had significantly lower body temperatures, OAA/S scale scores, and intraoperative shivering rates than the control group (P<0.05). Sedation with Dex has good efficacy in PCNL under epidural anesthesia. Dex can effectively prevent perioperative shivering and elicits low respiratory inhibition. Additionally, 0.5 mu g/kg Dex may be superior to 0.75 mu g/kg Dex in reducing the incidence and severity of bradycardia.