J Korean Assoc Oral Maxillofac Surg 2019; 45(3): 152~157
Sedation with dexmedetomidine in elderly patients during dental surgery: a retrospective case series
Mika Seto, Ryosuke Kita, Seiji Kondo
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
Mika Seto
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
TEL: +81-92-801-1011 FAX: +81-92-801-1044
E-mail: miichan@fukuoka-u.ac.jp
ORCID: https://orcid.org/0000-0002-7548-7613
Received July 30, 2018; Revised September 29, 2018; Accepted October 16, 2018.; Published online June 30, 2019.
© The Korean Association of Oral and Maxillofacial Surgeons.. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Objectives: The number of elderly patients with systemic basal disease requiring invasive dental treatment has increased. Appropriate prediction of surgical invasiveness and combined use of psychosedation are thought to contribute to safe whole-body management. Dexmedetomidine (DEX) exhibits analgesic and anti-anxiolytic properties and causes mild respiratory depression. Studies regarding DEX use in elderly non-intubated patients are scarce. We aimed to use retrospective data to determine an effective dose of DEX to induce adequate sedation in elderly patients undergoing invasive dental surgery under local anesthesia.
Materials and Methods: One hundred two patients aged 70 to 96 years were presumably appropriately controlled with sedation. DEX was administered at an initial loading dose of 2.0 to 3.1 μg/kg/hr for 10 minutes. We divided the patients into five groups by age and compared their blood pressures and heart rates.
Results: In all five groups, blood pressure decreased suddenly at approximately 15 and 20 minutes after DEX administration. A marked decrease in blood pressure was noted in patients aged 75 to 79 years.
Conclusion: For elderly patients aged 75 years and above, the initial loading dose of DEX needs to be reduced to lower than half that required for young and middle-age adults.
Keywords: Dexmedetomidine, Sedation, Elderly


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30 June 2019
Vol. 45
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