Hemodynamic instability following intravenous dexmedetomidine infusion for sedation under brachial plexus block: Two case reports  

作　　者：Ye Sull Kim Chanhong Lee Jeongmin Oh Seonhwa Nam A Ram Doo 

机构地区：[1]Department of Anesthesiology and Pain Medicine,Jeonbuk National University Hospital,Jeonju 54907,South Korea [2]Department of Anesthesiology and Pain Medicine,Jeonbuk National University Medical School and Hospital,Jeonju 54907,South Korea [3]Department of Anesthesiology and Pain Medicine,Research Institute of Clinical Medicine-Biomedical Research Institute of Jeonbuk National University Hospital,Jeonju 54907,South Korea

出　　处：《World Journal of Clinical Cases》2023年第30期7469-7474,共6页世界临床病例杂志

基　　金：Supported by the Fund of Biomedical Research Institute,Jeonbuk National University Hospital,Jeonju,Republic of Korea.

摘　　要：BACKGROUND Dexmedetomidine(DMED)is frequently used as a sedative in several medical fields.The benefits of DMED include enhanced quality of regional anesthesia,prolonged analgesia,and postoperative opioid-sparing when administered intravenously or perineurally in combination with regional anesthesia.Severe hemodynamic complications,such as profound bradycardia and hypotension,can occur after DMED administration in critically ill patients or overdosage;however,there are few reports of complications with DMED administration following brachial plexus block(BPB).CASE SUMMARY We present two cases of hemodynamic instability that occurred following the initial loading of DMED under supraclavicular BPB.A healthy 29-year-old man without any medical history showed profound bradycardia after receiving a loading dose of DMED 0.9μg/kg for 9 min.DMED administration was promptly stopped,and after receiving a second dose of atropine,the heart rate recovered.A 62-year-old woman with a history of cardiomyopathy became hypotensive abruptly,requiring the administration of inotrope and vasopressors after receiving a reduced loading dose of 0.5μg/kg for 10 min.Half of the recommended loading dose of DMED was administered due to the underlying heart dysfunction.Decrea-sed blood pressure was maintained despite the intravenous administration of ephedrine.With continuous infusion of dopamine and norepinephrine,the vital signs were maintained within normal ranges.Inotropic and vasopressor support was required for over 6 h after the initial loading dose of DMED.CONCLUSION DMED administration following BPB could trigger hemodynamic instability in patients with decreased cardiac function as well as in healthy individuals.

关 键 词：DEXMEDETOMIDINE Brachial plexus block Profound bradycardia Complication HYPOTENSION Instability Case report 

分 类 号：R737.9[医药卫生—肿瘤]