Abstract
The effective management of sedation and analgesia in severe chronic obstructive pulmonary disease patients provides a challenge to the anaesthesiologists and critical care practitioners. Choosing the appropriate agent or combination of agents for sedation is crucial in order to alleviate noxious stimuli, stress and anxiety while minimizing the risk of adverse events. We selected epidural anaesthesia and dexmedetomidine to preserve spontaneous breathing and obtained appropriate sedative and analgesic effect without causing respiratory depression and hemodynamic changes in a patient diagnosed to have chronic obstructive pulmonary disease undergoing femoral to tibial bypass with amputation of right foot.Journal of Society of Anesthesiologists of Nepal 2015; 2(1): 34-36
Highlights
Interest in the role of alpha (α)-2-adrenoceptor agonists in anaesthesia and intensive care is growing
Dexmedetomidine was given in bolus dose of 1 μg/kg over 10 minutes followed by a continuous intravenous infusion at a dose of 0.2 to 0.7 μg/kg/h titrated to a Ramsay sedation scale score of 4 throughout surgery
Since dexmedetomidine does not negatively affect the respiratory rate or depth compared to other sedatives, it has proven to be advantageous in high risk patients
Summary
Anubhav Sharma*, Madindra Basnet**, Bishwas Pradhan** *Tribhuvan University Teaching Hospital, Institute of medicine, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal. **Manmohan Cardiothoracic Vascular and Transplant Centre, Maharajgunj Medical Campus, Institute of ARTICLE INFO Article history Received 11.12.2014 Published 26.02.2015 © Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of the work’s authorship and initial publication in this journal.
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