Background: This study evaluated the effect of adding DEX to a total intravenous anesthetic on
hemodynamic control and emergence, and requirement for antihypertensive therapy and
long acting opiates. Materials and Methods: Thirty nine ASA I-III patients were enrolled into this prospective, single blind,
randomized study. All patients received a standardized anesthetic and were randomized
to propofol (PROP) or propofol plus DEX (0.2-0.7 mcg/kg/hr) infusions during surgery.
Hemodynamic data is collected continuously during the case. The emergence was videotaped
and analyzed for the number of episodes and severity of coughing. Hospital length
of stay was also examined. Data is analyzed using ANOVA with repeated measures and
the Kruskal-Wallis test. Results: Demographic data is similar among the 2 groups. There were no adverse events or neurological
outcomes in either group related to the anesthetic. Video analysis of emergence showed
a tendency of increased coughing episodes for PROP vs. DEX: 5.6 ± 8.3 vs. 1.1 ± 1.3
(P = 0.04) while surgeons’ ratings were similar for both groups (P = 0.35). Mean arterial blood pressure (MAP) significantly decreased intra-operatively
from baseline within groups but was not different between groups. The length of hospital
stay was not significantly different for DEX and PROP groups: 2.6 ± 1.9, and 3.2 ±
1.9 days, respectively. Conclusion: DEX appears to reduce coughing therefore providing a more favorable emergence when
compared to PROP. PROP + DEX is hemodynamically stable than PROP
