Journal of Yeungnam Medical Science

Original article

Anesthesiology and Pain Medicine
Effect of intrathecal fentanyl on dexmedetomidine requirement for sedation during spinal anesthesia: a randomized controlled trial: Ki Beom Park, Ji-Yong Yeom, Juhee Min, Hyeon Seung Yi, Gaeul Hur, Eun Kyung Choi; J Yeungnam Med Sci. 2026;43:47. Published online July 9, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.47

821 View
77 Download

Abstract PDF: Background
Adequate sedation during spinal anesthesia requires careful titration to avoid hemodynamic instability and respiratory complications. We hypothesized that intrathecal fentanyl, used as an adjunct to neuraxial anesthesia, would reduce dexmedetomidine requirements for conscious sedation. This study evaluated the effects of intrathecal fentanyl on the total dose of dexmedetomidine during spinal anesthesia.
Methods
Sixty-four patients undergoing knee or ankle arthroscopy under spinal anesthesia were randomly assigned to two groups. The fentanyl group received 0.5% bupivacaine 10 mg with fentanyl 20 μg, whereas the control group received bupivacaine 10 mg with saline. After confirmation of sensory block, dexmedetomidine was infused at 1 μg/kg over 10 minutes and maintained at 0.1–1 μg/kg/hour to maintain a bispectral index (BIS) of 70 to 80. The primary outcome was the total dose of dexmedetomidine. Secondary outcomes included BIS values, Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) scores, mean blood pressure, and heart rate at predefined time points.
Results
The total dose of dexmedetomidine did not differ significantly between the groups. The MOAA/S scores were significantly affected by group, time, and group-by-time interactions (p=0.003, p<0.001, and p=0.007, respectively). The BIS values were influenced by group (p=0.026) and time (p<0.001), but not by group-by-time interactions (p=0.413). Exploratory analyses suggested deeper sedation in the fentanyl group during the early phase of dexmedetomidine infusion. Hemodynamic variables were comparable between the groups.
Conclusion
Intrathecal fentanyl did not significantly reduce dexmedetomidine requirements during spinal anesthesia, although it was associated with deeper sedation at several time points.

Original Articles

Anesthesiology and Pain Medicine
Prophylactic intravenous ephedrine infusion during spinal anesthesia for cesarean section.: Bon Up Koo; Yeungnam Univ J Med. 1991;8(1):72-78. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.72

2,690 View
9 Download

Abstract PDF: Ephedrine sulfate was administrated 30 healthy parturients undergoing elective repeat cesarean section under spinal anesthesia. Fifteen patients received ephedrine infusion (0.01% solution, beginning with approximately 5 mg/min) immediately after induction of spinal anesthesia to maintain maternal systolic blood pressure between 90% and 100% of the baseline systolic blood pressure (mean dose of ephedrine 31.6 mg). Fifteen patients (control group) received 20mg of ephedrine as an intravenous bolus, and additional 10mg increments, if necessary, when systolic blood pressure decreased to 80% of the baseline systolic blood pressure (mean dose of ephedrine 26.8 mg). Nausea and/or vomiting occurred in seven women in the control group and on patient in the infusion group (p<0.001). Apgar scores, fetal blood gas tension, and time for onset of respiration was comparable in the two groups. The results suggest that prophylactic ephedrine infusion is safe and desirable in healthy parturients undergoing cesarean section under spinal anesthesia.

Anesthesiology and Pain Medicine
Spinal Anesthesia for Lower Extremities : Comparison of Plain 0.5% Bupivacaine and Hyperbaric 0.5% Tetracaine.: Sun Ok Song, Bon Up Koo; Yeungnam Univ J Med. 1990;7(2):121-130. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.121

3,148 View
6 Download

Abstract PDF: Plain 0.5% bupivacaine and hyperbaric 0.5% tetracaine were compared for spinal anesthesia in 40 patients undergoing operation of lower extremities. Lumbar puncture was performed with a 22 gauge spinal needle with the patient in the lateral recumbent position. The third lumbar interspace was chosen for the puncture, when a free flow of clear CSF was obtained, the local anesthetic solution (2.5 ml of 0.5% bupivacaine or 2.0 ml of hyperbaric 0.5% tetracaine) was injected at a rate of 0.1ml/sec without barbotage. After injection of anesthetics, clinical features were observed and compared between the two groups. The results were as follows: 1. The two groups were well matched for age, sex, height and weight. 2. In both groups, sensory block to T₁₂ dermatome was obtained within 4 minutes, mean maximal level of analgesia was T₆₋₇, and the mean time for maximal level was around 20 minutes. 3. The onset times of motor block were similar in both groups and complete motor block was obtained in all cases within 20 minutes. 4. The duration of analgesia above the T₁₂ dermatome was 3 hours, postoperative analgesia was 7 hours. These value were significantly prolonged than those of the tetracaine group (p<0.05). 5. The changes in systolic pressure in the bupivacaine group were significantly less than those of the tetracaine group (p<0.05). 6. The complications after spinal anesthesia were headache, numbness, urinary retention and backpain, and were no significant difference in both groups. From the obtained results, we concluded that plain 0.5% bupivacaine was a relatively satisfactory agent for spinal anesthesia for operation of lower extremities. The time of onset, height of block and the complications of postoperative period were similar in both groups. The advantages of plain 0.5% bupivacaine were less hypotension and long duration of analgesia.

First
Prev
Page of 1
Next
Last

Search