Sole use of dexmedetomidine for sedation and analgesia in patients undergoing endovenous thermal ablation for incompetent saphenous veins

Jin Ho Hwang, Il Soo Chang, Sang Woo Park, Won-Kyoung Kwon, Jae Joon Hwang


Background: Dexmedetomidine have both sedative and analgesic properties without respiratory- depressant effect. This study aims to evaluate the safety and effectiveness of sedation and analgesia using dexmedetomidine for the endovenous treatment of varicose veins.
Methods: This study included 88 patients (male =38, female =50; mean age, 48.7 years) who underwent endovenous laser or radiofrequency ablation of saphenous vein. At the beginning of sedation, dexmedetomidine was administered intravenously to all patients with a loading dose of 1 μg/kg over 15 minutes, which was followed by a maintenance dose of 0.2 μg/kg/h throughout the procedure. Peripheral oxygen saturation, systolic and diastolic blood pressure, heart rate and respiratory rate, and the induction and recovery time were assessed. The degree of pain was recorded by using a 10-point visual analog scale after the procedure. Adverse events associated with sedation/analgesia were also recorded.
Results: Eighty-five patients responded adequately to sole use of dexmedetomidine. The mean induction time was 17.5 minutes. The mean visual analog scale pain score during the procedure was 2.3±2.0. Maximum pain scores of 4 (discomforting) or less were recorded in 69 (78.4%) patients. Six (6.8%) patients complained of pain scores in excess of 7. Systolic and diastolic blood pressure and heart rate drop between 0 and 15 minutes were 18.2/9.3 mmHg and 13.5 beat/min, respectively. Three (3.5%) patients required cessation of infusion due to significant decrease in of blood pressure or heart rate. There was no hypoxic or resuscitation event during the procedures.
Conclusions: Dexmedetomidine can provide excellent sedative and analgesic effect during endovenous thermal ablation.