ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2022
Association of intraoperative dexmedetomidine use with postoperative hypotension in unilateral hip and knee arthroplasties: a historical cohort study.
Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Effects of dexmedetomidine on early postoperative cognitive function and postoperative inflammatory response: a systematic review and network meta-analysis.Frontiers in neurology · 2024Pooled it
- Comparison of the Safety and Efficacy of CiprofolCurrent medicinal chemistry · 2026Trial
- Assessment of risk factors for the development of postoperative hypotension in patients undergoing colorectal surgery: a historical cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026Article
- Comparison on the Effectiveness of Intravenous Magnesium Sulphate and Intravenous Dexmedetomidine in Reducing Emergence Agitation in Adults Undergoing Otorhinolaryngology Surgery.Anesthesiology research and practice · 2026Article
- Acute adrenal insufficiency-induced hypotension following spinal surgery in a pediatric patient with Charcot-Marie-Tooth disease and severe scoliosis: a case report.BMC pediatrics · 2025Article
- Key Risk Factors for Postoperative Hypotension in Nasopharyngeal Carcinoma Patients After Endoscopic Surgery: A Retrospective Study.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Article
- Multimodal anesthesia for hemicorporectomy suggests creating a standardized anesthesia guideline: a case report.Annals of translational medicine · 2025Article
- Is remimazolam the future of sedation for regional anesthesia?Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Article
- The optimal dose of dexmedetomidine as a 0.59% ropivacaine adjuvant for epidural anesthesia in great saphenous varicose vein surgery, based on hemodynamics and anesthesia efficacy: a randomized, controlled, double-blind clinical trial.Frontiers in medicine · 2024Article
- Perioperative Hypotension in Patients Undergoing Orthopedic Upper Extremity Surgery with Dexmedetomidine Sedation: A Retrospective Study.Journal of personalized medicine · 2023Article
- Periarticular infiltration used in total joint replacements: an update and review article.Journal of orthopaedic surgery and research · 2023Review
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7 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeDexmedetomidine is frequently used as a sedative agent for orthopedic surgery patients undergoing total hip or knee arthroplasty. Although the benefits of dexmedetomidine are well described in the literature, there is also potential for harm, especially regarding the hemodynamic effects of dexmedetomidine in the postoperative setting.
methodsThis historical cohort study included all primary unilateral total hip or knee arthroplasties conducted from April 2017 to February 2020 in a single, university-affiliated, tertiary care centre (Jewish General Hospital, Montreal, QC, Canada). We used multivariable logistic regression to analyze the predictors for postoperative hypotension, defined as a systolic blood pressure < 90 mm Hg or any systolic blood pressure while on a vasopressor infusion in the postanesthesia care unit. Models were validated using calibration and discrimination with bootstrapping technique.
resultsOne thousand five hundred and eighty-eight patients were included in this study. Postoperative hypotension occurred in 413 (26%) patients. Statistically significant predictors for postoperative hypotension included female sex (adjusted odds ratio [aOR], 3.24; 95% confidence interval [CI], 2.29 to 4.58), a history of transient ischemic attack or cerebrovascular accident (aOR, 1.97; 95% CI, 1.04 to 3.72), and intraoperative dexmedetomidine use (aOR, 2.61; 95% CI, 1.99 to 3.42). Moreover, the risk of postoperative hypotension was approximately two times higher than baseline, with a total intraoperative dexmedetomidine dose above 50 μg (relative risk, 1.99; 95% CI, 1.63 to 2.44; P < 0.001). A higher preoperative systolic blood pressure (aOR, 0.98; 95% CI, 0.97 to 0.99) was a protective factor for postoperative hypotension.
conclusionIn this historical cohort study, dexmedetomidine was a strong risk factor for postoperative hypotension in total hip or knee arthroplasty patients. Dexmedetomidine, and particularly at high cumulative doses above 50 μg, should be administered judiciously in high-risk surgical patients to minimize the risk of postoperative hypotension.
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