25 September 2023 : Clinical Research
Impact of Nonselective and Selective α-1 Adrenergic Blockers on the Sedative Efficacy of Dexmedetomidine in Urologic Surgery: A Prospective, Observational Study
Jiseok Baik
12DEF, Ohyun Kim 1B, Soeun Jeon 3C, Hyae Jin Kim 12BE, Boo-young Hwang 12BD, Dowon Lee 12ADEF*
DOI: 10.12659/MSM.941614
Med Sci Monit 2023; 29:e941614
Table 3 The change (Δ) in the bispectral index (BIS) (A), Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) scale (B), oxygen saturation (SpO2) (C), heart rate (HR) (D), and mean blood pressure (MBP) (E).
| (A) | ||||
|---|---|---|---|---|
| BIS | Group N (n=33) | Group NS (n=27) | Group S (n=58) | JT test (P value) |
| BIS, baseline | 96.0 (94.0, 98.0) | 96.0 (92.0, 98.0) | 96.0 (93.8, 98.0) | 0.240 |
| Δ BIS (5 min) | −7.0 (−13.0, −4.0) | −7.0 (−9.0, −4.0) | −8.0 (−11.5, −4.0) | 0.476 |
| Δ BIS (10 min) | −22.0 (−30.0, −12.0) | −12.0 (−20.0, −9.0) | −19.0 (−31.3, −11.8) | 0.091 |
| Δ BIS (15 min) | −31.0 (−39.5, −18.0) | −24.0 (−36.0, −18.0) | −33.5 (−40.3, −18.0) | 0.270 |
| Δ BIS (20 min) | −37.0 (−47.0, −24.5) | −28.0 (−39.0. −20.0) | −40.0 (−48.0, −30.5) | 0.059 |
| Δ BIS (25 min) | −43.0 (−50.0, −32.5)b | −30.0 (−40.0, −22.0),a | −41.5 (−49.0, −33.0)b | 0.013 |
| Δ BIS (30 min) | −44.0 (−50.0, −34.0)b | −34.0 (−43.0, −26.0),a | −44.5 (−50.3, −33.8)b | 0.015 |
| Δ means the change between the baseline (0 min) and each time point (5, 10, 15, 20, 25, and 30 min) after beginning the loading infusion of dexmedetomidine. Data are presented as the median and interquartile range (IQR). a b c JT test – Jonckheere-Terpstra test; Group N – no medication group; Group NS – nonselective α−1 blocker medication group; Group S – selective α−1 blocker medication group. | ||||
| (B) | ||||
| MOAA/S | Group N (n=33) | Group NS (n=27) | Group S (n=58) | JT test (P value) |
| MOAA/S, baseline | 5.0 (5.0, 5.0) | 5.0 (5.0, 5.0) | 5.0 (5.0, 5.0) | 0.246 |
| Δ MOAA/S (5 min) | 0 (−1.0, 0) | 0 (0, 0) | 0 (−1.0, 0) | 0.393 |
| Δ MOAA/S (10 min) | −1 (−2.0, −1.0) | −1 (−2.0, −1.0) | −2 (−3.0, −1.0) | 0.990 |
| Δ MOAA/S (15 min) | −2 (−3.0, −2.0) | −3 (−4.0, −2.0) | −3 (−4.0, −2.0) | 0.441 |
| Δ MOAA/S (20 min) | −3 (−4.0, −2.0) | −3 (−4.0, −2.0) | −4 (−4.3, −2.8) | 0.245 |
| Δ MOAA/S (25 min) | −3 (−4.0, −3.0) | −4 (−5.0,−3.0) | −4 (−5.0,−3.0) | 0.172 |
| Δ MOAA/S (30 min) | −4 (−4.0, −3.5) | −4 (−5.0, −3.0) | −4 (−5.0, −3.0) | 0.211 |
| Δ means the change between the baseline (0 min) and each time point (5, 10, 15, 20, 25, and 30 min) after beginning the loading infusion of dexmedetomidine. Data are presented as the median and interquartile range (IQR). a b c JT test – Jonckheere-Terpstra test; Group N – no medication group; Group NS – nonselective α−1 blocker medication group; Group S – selective α−1 blocker medication group. | ||||
| (C) | ||||
| SpO2 (%) | Group N (n=33) | Group NS (n=27) | Group S (n=58) | JT test (P value) |
| SpO, baseline | 98.0 (97.0, 99.0) | 98.0 (97.0, 99.0) | 98.0 (96.0, 99.0) | 0.770 |
| Δ SpO (5 min) | 0 (−1.0, 0) | 0 (−1.0, 0) | 0 (−1.0, 1.0) | 0.736 |
| Δ SpO (10 min) | 0 (−1.0, 0) | −1 (−2.0, 0) | 0 (−2.0, 1.3) | 0.251 |
| Δ SpO (15 min) | −1 ( −1.0, 0.5) | −1 (−2.0, 0) | −1 (−2.0, 1.0) | 0.633 |
| Δ SpO (20 min) | −1 (−2.0, 0) | −1 (−2.0, 0) | 0 (−2.0, 1.3) | 0.766 |
| Δ SpO (25 min) | −1 (−2.0, 1.0) | −1 (−2.0, 1.0) | −1 (−2.0, 1.0) | 0.930 |
| Δ SpO (30 min) | −1 (−1.5, 1.0) | −1 (−2.0, 1.0) | 0 (−2.0, 1.0) | 0.859 |
| Δ means the change between the baseline (0 min) and each time point (5, 10, 15, 20, 25, and 30 min) after beginning the loading infusion of dexmedetomidine. Data are presented as the median and interquartile range (IQR). a b c JT test – Jonckheere-Terpstra test; Group N – no medication group; Group NS – nonselective α−1 blocker medication group; Group S – selective α−1 blocker medication group. | ||||
| (D) | ||||
| HR (bpm) | Group N (n=33) | Group NS (n=27) | Group S (n=58) | JT test (P value) |
| HR, baseline | 71.0 (64.0, 80.5) | 72.0 (62.0, 78.0) | 68.0 (62.8, 76.8) | 0.849 |
| Δ HR (5 min) | −9 (−13.5, −7.0) | −12 (−22.0, −7.0) | −12 (−19.0, −8.0) | 0.147 |
| Δ HR (10 min) | −15 (−22.0, −10.5) | −16 (−24.0, −9.0) | −15 (−25.0, −9.8) | 0.996 |
| Δ HR (15 min) | −16 (−21.0, −11.5) | −12 (−21.0, −8.0) | −13 (−22.3, −7.5) | 0.362 |
| Δ HR (20 min) | −16 (−21.5, −9.5) | −12 (−21.0, −7.0) | −15.5 (−21.3, −8.0) | 0.130 |
| Δ HR (25 min) | −18 (−22.0, −10.0) | −12 (−12.0, −8.0) | −13.5 (−21.0, −8.0) | 0.123 |
| Δ HR (30 min) | −17 (−25.0, −10.0) | −12 (−19.0, −7.0) | −14 (−19.3, −7.0) | 0.129 |
| Δ means the change between the baseline (0 min) and each time point (5, 10, 15, 20, 25, and 30 min) after beginning the loading infusion of dexmedetomidine. Data are presented as the median and interquartile range (IQR). a b c JT test – Jonckheere-Terpstra test; Group N – no medication group; Group NS – nonselective α−1 blocker medication group; Group S – selective α−1 blocker medication group. | ||||
| (E) | ||||
| MBP (mmHg) | Group N (n=33) | Group NS (n=27) | Group S (n=58) | JT test (P value) |
| MBP, baseline | 89.0 (84.0, 101.0) | 97.0 (85.0, 104.0) | 95.0 (84.8, 103.0) | 0.173 |
| MBP (5 min)Δ | −1 (−3.0, 5.0) | 6 (−6.0, 13.0) | 7.5 (−1.0, 12.3) | 0.070 |
| MBP (10 min)Δ | −3 (−9.5, 9.0),b | 11 (−3.0, 18.0)a | 7.5 (−2.0, 19.3)a | 0.013 |
| MBP (15 min)Δ | −10 (−13.0, 6.0),b | 4 (−4.0, 20.0)a | 7 (−1.0, 17.5)a | 0.007 |
| MBP (20 min)Δ | −7 (−14.5, 5.5),b | 3 (−3.0, 18.0)a | 4.5 (−4.3, 15.3)a | 0.017 |
| MBP (25 min)Δ | −9 (−17.5, 7.0),b | 0 (−5.0, 11.0)a | 2 (−6.3, 15.3)a | 0.011 |
| MBP (30 min)Δ | −9 (−16.5, 3.0),b | −1 (−7.0, 17.0)a | 5 (−6.0, 13.0)a | 0.007 |
| Δ means the change between the baseline (0 min) and each time point (5, 10, 15, 20, 25, and 30 min) after beginning the loading infusion of dexmedetomidine. Data are presented as the median and interquartile range (IQR). a b c JT test – Jonckheere-Terpstra test; Group N – no medication group; Group NS – nonselective α−1 blocker medication group; Group S – selective α−1 blocker medication group. | ||||