Intranasal dexmedetomidine in elderly subjects with or without beta blockade: a randomised double-blind single-ascending-dose cohort study.

beta-blockade complication dexmedetomidine elderly hypotension intranasal safety sedation

Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
03 Feb 2020
Historique:
received: 16 03 2019
revised: 18 11 2019
accepted: 16 12 2019
entrez: 8 2 2020
pubmed: 8 2 2020
medline: 8 2 2020
Statut: aheadofprint

Résumé

The aim of this double-blind, placebo-controlled, single-ascending-dose study was to determine the safety and tolerability of intranasal dexmedetomidine in the elderly. We randomly assigned 48 surgical patients ≥65 yr of age to receive single intranasal doses of dexmedetomidine or placebo (5:1 ratio) in four sequential dose cohorts: 0.5, 1.0, 1.5, and 2.0 μg kg One subject (1.0 μg kg Intranasal dexmedetomidine in elderly subjects had a sedative effect, but caused a high incidence of profound and sustained hypotension irrespective of β-blocker use. The technique is unsuitable for routine clinical use. NTR5513 (The Netherlands Trial Registry 5513).

Sections du résumé

BACKGROUND BACKGROUND
The aim of this double-blind, placebo-controlled, single-ascending-dose study was to determine the safety and tolerability of intranasal dexmedetomidine in the elderly.
METHODS METHODS
We randomly assigned 48 surgical patients ≥65 yr of age to receive single intranasal doses of dexmedetomidine or placebo (5:1 ratio) in four sequential dose cohorts: 0.5, 1.0, 1.5, and 2.0 μg kg
RESULTS RESULTS
One subject (1.0 μg kg
CONCLUSIONS CONCLUSIONS
Intranasal dexmedetomidine in elderly subjects had a sedative effect, but caused a high incidence of profound and sustained hypotension irrespective of β-blocker use. The technique is unsuitable for routine clinical use.
CLINICAL TRIAL REGISTRATION BACKGROUND
NTR5513 (The Netherlands Trial Registry 5513).

Identifiants

pubmed: 32029262
pii: S0007-0912(19)31015-3
doi: 10.1016/j.bja.2019.12.025
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Auteurs

Clemens R M Barends (CRM)

Department of Anaesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: c.r.m.barends@umcg.nl.

Mendy K Driesens (MK)

Department of Anaesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Michel M R F Struys (MMRF)

Department of Anaesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Basic and Applied Medical Sciences, Ghent University, Ghent, Belgium.

Anita Visser (A)

Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Anthony R Absalom (AR)

Department of Anaesthesiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Classifications MeSH