@article{oai:asahikawa-med.repo.nii.ac.jp:00005710,
 author = {国沢, 卓之 and 藤本, 一弘 and 黒澤, 温 and 長島, 道生 and 松井, 康二 and 林, 大 and 山本, 邦彦 and 後藤, 祐也 and 阿久津, 弘明 and 岩崎, 寛},
 issue = {10},
 journal = {Therapeutics and Clinical Risk Management},
 month = {Oct},
 note = {PURPOSE:
\nThe general dexmedetomidine (DEX) concentration required for sedation of intensive care unit patients is considered to be approximately 0.7 ng/mL. However, higher DEX concentrations are considered to be required for sedation and/or pain management after major surgery using remifentanil. We determined the DEX concentration required after major surgery by using a target-controlled infusion (TCI) system for DEX.
METHODS:
\nFourteen patients undergoing surgery for abdominal aortic aneurysms (AAA) were randomly, double-blindly assigned to two groups and underwent fentanyl- or remifentanil-based anesthetic management. DEX TCI was started at the time of closing the peritoneum and continued for 12 hours after stopping propofol administration (M0); DEX TCI was adjusted according to the sedation score and complaints of pain. The doses and concentrations of all anesthetics and postoperative conditions were investigated.
RESULTS:
\nThroughout the observation period, the predicted plasma concentration of DEX in the fentanyl group was stable at approximately 0.7 ng/mL. In contrast, the predicted plasma concentration of DEX in the remifentanil group rapidly increased and stabilized at approximately 2 ng/mL. The actual DEX concentration at 540 minutes after M0 showed a similar trend (0.54±0.14 [fentanyl] versus 1.57±0.39 ng/mL [remifentanil]). In the remifentanil group, the dopamine dose required and the duration of intubation decreased, and urine output increased; however, no other outcomes improved.
CONCLUSION:
\nThe DEX concentration required after AAA surgery with remifentanil was three-fold higher than that required after AAA surgery with fentanyl or the conventional DEX concentration for sedation. High DEX concentration after remifentanil affords some benefits in anesthetic management., This articles under a Creative Commons Attribution Non-Commercial license (CC-BY-NC)., text, application/pdf},
 pages = {797--806},
 title = {The dexmedetomidine concentration required after remifentanil anesthesia is three-fold higher than that after fentanyl anesthesia or that for general sedation in the ICU.},
 year = {2014},
 yomi = {クニサワ, タカユキ and フジモト, カズヒロ and クロサワ, アツシ and ナガシマ, ミチオ and マツイ, コウジ and ハヤシ, ダイ and ヤマモト, クニヒコ and ゴトウ, ユウヤ and アクツ, ヒロアキ and イワサキ, ヒロシ}
}