Dexmedetomidine in combination with fentanyl and midazolam can induce serious respiratory depression
Abstract
The aim of our study was to assess the safety and effects of a new alpha2 sympathoadrenergic drug dexmedetomidine combined with midazolam and fentanyl. Material and methods: A prospective randomised double blinded clinical study in patients scheduled for laparoscopic cholecystectomy was performed.
Dexmedetomidine potentiates the sedative effect of midazolam and significantly potentiates the effect of midazolam and fentanyl on respiratory depression. Dexmedetomidine in combination with fentanyl and midazolam suppresses adverse hemodynamic effects of capnoperitoneum, decreases perioperative fentanyl consumption and prolongs the time to analgesia request after surgery, produces mild to moderate sedation, but can result in serious respiratory depression.
The patient after administration of the combination of dexmedetomidine and midazolam with fentanyl needs close observation because of risk of vital functions disturbances and this combination cannot be used in standard praxis. Because of this reason, we have abandoned further research of this combination