Autonomic nervous system responses during sedative infusions of dexmedetomidine

Charles W. Hogue, Pekka Talke, Phyllis K. Stein, Charles Richardson, Peter P. Domitrovich, Daniel I. Sessler

Research output: Contribution to journalArticle

Abstract

Background: The purpose of this study was to determine the effects of dexmedetomidine on systemic and cardiac autonomic reflex responses during rest and during thermal stress. Methods: Volunteers received either placebo or low- or highdose dexmedetomidine (target plasma concentrations 0.3 or 0.6 ng/ml, respectively) infusions in a prospectively randomized, double-blinded crossover study design. After 1 h, baroreflex sensitivity was assessed, and then core body temperature was raised to the sweating threshold and then lowered to the shivering threshold. Plasma catecholamines and blood pressure were measured, and cardiac autonomic responses were assessed by analysis of heart rate variability. Results: Compared with placebo, plasma norepinephrine concentrations, blood pressure, heart rate, and some heart rate variability measures were lower after 1-h infusion of dexmedetomidine, but baroreflex responses did not differ significantly. Dexmedetomidine blunted the systemic and cardiac sympathetic effects of sweating observed during placebo infusion but had no effect on parasympathetic measures. Increases in blood pressure, and systemic catecholamines; due to shivering were observed during placebo and dexmedetomidine, but these responses were less with dexmedetomidine. During shivering, dexmedetomidine infusion was associated with higher low-frequency and high-frequency heart rate variability power but lower heart rate compared with the sweating threshold and with the control period, suggesting nonreciprocal cardiac autonomic responses. Conclusions: Infusion of dexmedetomidine results in compensated reductions in systemic sympathetic tone without changes in baroreflex sensitivity. Dexmedetomidine blunts heart rate and the systemic sympathetic activation due to sweating, but it is less effective in blunting cardiac sympathetic responses to shivering. During dexmedetomidine infusion, cardiac sympathetic and parasympathetic tone may have nonreciprocal changes during shivering.

Original languageEnglish (US)
Pages (from-to)592-598
Number of pages7
JournalAnesthesiology
Volume97
Issue number3
DOIs
StatePublished - Sep 2002
Externally publishedYes

Fingerprint

Dexmedetomidine
Autonomic Nervous System
Hypnotics and Sedatives
Shivering
Sweating
Heart Rate
Baroreflex
Placebos
Blood Pressure
Cross-Over Studies
Catecholamines
Body Temperature
Reflex
Volunteers
Norepinephrine
Hot Temperature

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Hogue, C. W., Talke, P., Stein, P. K., Richardson, C., Domitrovich, P. P., & Sessler, D. I. (2002). Autonomic nervous system responses during sedative infusions of dexmedetomidine. Anesthesiology, 97(3), 592-598. https://doi.org/10.1097/00000542-200209000-00012

Autonomic nervous system responses during sedative infusions of dexmedetomidine. / Hogue, Charles W.; Talke, Pekka; Stein, Phyllis K.; Richardson, Charles; Domitrovich, Peter P.; Sessler, Daniel I.

In: Anesthesiology, Vol. 97, No. 3, 09.2002, p. 592-598.

Research output: Contribution to journalArticle

Hogue, CW, Talke, P, Stein, PK, Richardson, C, Domitrovich, PP & Sessler, DI 2002, 'Autonomic nervous system responses during sedative infusions of dexmedetomidine', Anesthesiology, vol. 97, no. 3, pp. 592-598. https://doi.org/10.1097/00000542-200209000-00012
Hogue CW, Talke P, Stein PK, Richardson C, Domitrovich PP, Sessler DI. Autonomic nervous system responses during sedative infusions of dexmedetomidine. Anesthesiology. 2002 Sep;97(3):592-598. https://doi.org/10.1097/00000542-200209000-00012
Hogue, Charles W. ; Talke, Pekka ; Stein, Phyllis K. ; Richardson, Charles ; Domitrovich, Peter P. ; Sessler, Daniel I. / Autonomic nervous system responses during sedative infusions of dexmedetomidine. In: Anesthesiology. 2002 ; Vol. 97, No. 3. pp. 592-598.
@article{ebf51f34627742988269c4743c198789,
title = "Autonomic nervous system responses during sedative infusions of dexmedetomidine",
abstract = "Background: The purpose of this study was to determine the effects of dexmedetomidine on systemic and cardiac autonomic reflex responses during rest and during thermal stress. Methods: Volunteers received either placebo or low- or highdose dexmedetomidine (target plasma concentrations 0.3 or 0.6 ng/ml, respectively) infusions in a prospectively randomized, double-blinded crossover study design. After 1 h, baroreflex sensitivity was assessed, and then core body temperature was raised to the sweating threshold and then lowered to the shivering threshold. Plasma catecholamines and blood pressure were measured, and cardiac autonomic responses were assessed by analysis of heart rate variability. Results: Compared with placebo, plasma norepinephrine concentrations, blood pressure, heart rate, and some heart rate variability measures were lower after 1-h infusion of dexmedetomidine, but baroreflex responses did not differ significantly. Dexmedetomidine blunted the systemic and cardiac sympathetic effects of sweating observed during placebo infusion but had no effect on parasympathetic measures. Increases in blood pressure, and systemic catecholamines; due to shivering were observed during placebo and dexmedetomidine, but these responses were less with dexmedetomidine. During shivering, dexmedetomidine infusion was associated with higher low-frequency and high-frequency heart rate variability power but lower heart rate compared with the sweating threshold and with the control period, suggesting nonreciprocal cardiac autonomic responses. Conclusions: Infusion of dexmedetomidine results in compensated reductions in systemic sympathetic tone without changes in baroreflex sensitivity. Dexmedetomidine blunts heart rate and the systemic sympathetic activation due to sweating, but it is less effective in blunting cardiac sympathetic responses to shivering. During dexmedetomidine infusion, cardiac sympathetic and parasympathetic tone may have nonreciprocal changes during shivering.",
author = "Hogue, {Charles W.} and Pekka Talke and Stein, {Phyllis K.} and Charles Richardson and Domitrovich, {Peter P.} and Sessler, {Daniel I.}",
year = "2002",
month = "9",
doi = "10.1097/00000542-200209000-00012",
language = "English (US)",
volume = "97",
pages = "592--598",
journal = "Anesthesiology",
issn = "0003-3022",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Autonomic nervous system responses during sedative infusions of dexmedetomidine

AU - Hogue, Charles W.

AU - Talke, Pekka

AU - Stein, Phyllis K.

AU - Richardson, Charles

AU - Domitrovich, Peter P.

AU - Sessler, Daniel I.

PY - 2002/9

Y1 - 2002/9

N2 - Background: The purpose of this study was to determine the effects of dexmedetomidine on systemic and cardiac autonomic reflex responses during rest and during thermal stress. Methods: Volunteers received either placebo or low- or highdose dexmedetomidine (target plasma concentrations 0.3 or 0.6 ng/ml, respectively) infusions in a prospectively randomized, double-blinded crossover study design. After 1 h, baroreflex sensitivity was assessed, and then core body temperature was raised to the sweating threshold and then lowered to the shivering threshold. Plasma catecholamines and blood pressure were measured, and cardiac autonomic responses were assessed by analysis of heart rate variability. Results: Compared with placebo, plasma norepinephrine concentrations, blood pressure, heart rate, and some heart rate variability measures were lower after 1-h infusion of dexmedetomidine, but baroreflex responses did not differ significantly. Dexmedetomidine blunted the systemic and cardiac sympathetic effects of sweating observed during placebo infusion but had no effect on parasympathetic measures. Increases in blood pressure, and systemic catecholamines; due to shivering were observed during placebo and dexmedetomidine, but these responses were less with dexmedetomidine. During shivering, dexmedetomidine infusion was associated with higher low-frequency and high-frequency heart rate variability power but lower heart rate compared with the sweating threshold and with the control period, suggesting nonreciprocal cardiac autonomic responses. Conclusions: Infusion of dexmedetomidine results in compensated reductions in systemic sympathetic tone without changes in baroreflex sensitivity. Dexmedetomidine blunts heart rate and the systemic sympathetic activation due to sweating, but it is less effective in blunting cardiac sympathetic responses to shivering. During dexmedetomidine infusion, cardiac sympathetic and parasympathetic tone may have nonreciprocal changes during shivering.

AB - Background: The purpose of this study was to determine the effects of dexmedetomidine on systemic and cardiac autonomic reflex responses during rest and during thermal stress. Methods: Volunteers received either placebo or low- or highdose dexmedetomidine (target plasma concentrations 0.3 or 0.6 ng/ml, respectively) infusions in a prospectively randomized, double-blinded crossover study design. After 1 h, baroreflex sensitivity was assessed, and then core body temperature was raised to the sweating threshold and then lowered to the shivering threshold. Plasma catecholamines and blood pressure were measured, and cardiac autonomic responses were assessed by analysis of heart rate variability. Results: Compared with placebo, plasma norepinephrine concentrations, blood pressure, heart rate, and some heart rate variability measures were lower after 1-h infusion of dexmedetomidine, but baroreflex responses did not differ significantly. Dexmedetomidine blunted the systemic and cardiac sympathetic effects of sweating observed during placebo infusion but had no effect on parasympathetic measures. Increases in blood pressure, and systemic catecholamines; due to shivering were observed during placebo and dexmedetomidine, but these responses were less with dexmedetomidine. During shivering, dexmedetomidine infusion was associated with higher low-frequency and high-frequency heart rate variability power but lower heart rate compared with the sweating threshold and with the control period, suggesting nonreciprocal cardiac autonomic responses. Conclusions: Infusion of dexmedetomidine results in compensated reductions in systemic sympathetic tone without changes in baroreflex sensitivity. Dexmedetomidine blunts heart rate and the systemic sympathetic activation due to sweating, but it is less effective in blunting cardiac sympathetic responses to shivering. During dexmedetomidine infusion, cardiac sympathetic and parasympathetic tone may have nonreciprocal changes during shivering.

UR - http://www.scopus.com/inward/record.url?scp=0036725009&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036725009&partnerID=8YFLogxK

U2 - 10.1097/00000542-200209000-00012

DO - 10.1097/00000542-200209000-00012

M3 - Article

VL - 97

SP - 592

EP - 598

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 3

ER -