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BJA Advance Access published online on October 21, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei263
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted September 12, 2005

Case Report

Central apnoea after balanced general anaesthesia that included dexmedetomidine

A. M.-H. Ho 1*, S. Chen 1, and M. K. Karmakar 1

1 Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, PRC

* To whom correspondence should be addressed.
A. M.-H. Ho, E-mail: hoamh{at}hotmail.com


  Abstract

Dexmedetomidine is an {alpha}2-adrenoreceptor agonist that, in spite of its potent sedative, amnesic, and analgesic properties, has minimal respiratory depressant effect. Even at doses adequate for general anaesthesia, it does not cause central apnoea. Thus, it has been claimed that ‘combining {alpha}2-agonists with opiate narcotics or non-steroidal anti-inflammatory drugs can enhance the analgesic efficacy without increasing the respiratory depressant effect of the latter’ and ‘the combination of {alpha}2-adrenoceptor agonists with opioids does not lead to further ventilatory depression’. We present a case of central apnoea after general anaesthesia that included opioids and dexmedetomidine, and remind the readers that in susceptible patients, dexmedetomidine may cause life-threatening respiratory depression through potentiation of co-administered central nervous system depressants.

Keywords: agonists, {alpha}2-adrenergic; complications, apnoea; complications, respiratory failure; opiates; premedication, dexmedetomidine.
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