A Clinical Trial of Comparing Dexmedetomidine and Remifentanil on the Oximetry Parameters in the Patients with End-Stage Renal Disease Undergoing Arteriovenous Fistula Formation

Abstract

Background: Oximetry is a method for measuring the arterial hemoglobin saturation (SpO2) using pulse oximeter and is essential in any type of anesthetic procedures. The growing population of geriatrics in the recent decades in combination with an increase in the prevalence of chronic diseases including diabetes and hypertension are some of the leading causes for an increase in the prevalence of chronic kidney disease and end-stage renal disease (ESRD). The definite treatment for ESRD is renal transplant but unfortunately, it may take a long time to find a suitable kidney and continuing the patient's life may depend on dialysis. Arteriovenous fistula (AVF) formation is one of the first steps to prepare the patient for hemodialysis. ESRD itself is a reason for physical and psychosocial issues. Preparing a favorable condition for AVF surgery is essential to decrease the burden of the underlying disease. An efficient respiratory supply is necessary in all parts of an anesthetic procedures. Aims and Objectives: This study is a double-blind clinical trial to compare two anesthetic agents, dexmedetomidine and remifentanil in patients with ESRD who underwent AVF formation. Materials and Methods: SpO2 was measured on different phases including the time of initial incision, and after 10, 30, 60, 90, and 120 min of finishing the surgery. The data were analyzed using SPSS version 22, two-way repeated measures (ANOVA), and independent t-test. Results: This study showed that there was no any significant difference in using any of these two agents with regard to SpO2 in the different times of measurements during the anesthetic procedure and after the surgery in the recovery phase. Conclusion: This study showed that there is not any superiority in using DEX or REM in the patients undergo AVF formation. More studies on the other groups of the patients with different surgeries.