ATTENUATION OF HAEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION WITH INTRAVENOUS DEXMEDETOMIDINE BETWEEN TWO DOSES: A RANDOMIZED DOUBLE BLIND PROSPECTIVE STUDY
Main Article Content
Keywords
optimal dose of IV, dexmedetomidine, different doses, attenuation of haemodynamic stress, laryngoscopy, endotracheal intubation
Abstract
Aim: The aim of the present study is to determine an optimal dose of IV dexmedetomidine by comparing different doses of the drug in terms of attenuation of haemodynamic stress response to laryngoscopy and endotracheal intubation.
Methods: This Randomized Double blind prospective clinical study was conducted at Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka for the period of 6 months. The sample size calculated in each group was 35.Group A: IV dexmedetomidine 0.3 μg/kg diluted to 20 ml with normal saline was given over 10 min.Group B: IV dexmedetomidine 0.5 μg/kg diluted to 20 ml with normal saline was given over 10 min.
Results: The mean age in group A and group B were 34.46±8.22 and 37.83±9.41 years respectively. 51.4% were males and 48.6% were females in both the groups. In both the groups, heart rate and SBP showed statistically significant result in 1 minute, 3 minutes and 5 minutes respectively.The sedation scores were more in Group B as compared to Group A.
Conclusion: The use of 0.5μg / kg dexmedetomidine as an intravenous infusion is associated with reduced postoperative pain and appropriate hemodynamic stability during surgery, and this dose seems to be effective in preventing acute postoperative pain.
References
2. Sulaiman S, Karthekeyan RB, Vakamudi M, Sundar AS, Ravullapalli H, Gandham R. The effects of dexmedetomidine on attenuation of stress response to endotracheal intubation in patients undergoing elective off-pump coronary artery bypass grafting. Ann Card Anaesth. 2012 Jan-Mar;15(1):39-43.
3. Keniya VM, Ladi S, Naphade R. Dexmedetomidine attenuates sympathoadrenal response to tracheal intubation and reduces perioperative anaesthetic requirement. Indian J Anaesth. 2011 Jul;55(4):352-7.
4. Menda F, Köner O, Sayin M, Türe H, Imer P, Aykaç B. Dexmedetomidine as an adjunct to anesthetic induction to attenuate hemodynamic response to endotracheal intubation in patients undergoing fast-track CABG. Ann Card Anaesth. 2010 Jan-Apr;13(1):16-21.
5. Laha A, Ghosh S, Sarkar S. Attenuation of sympathoadrenal responses and anesthetic requirement by dexmedetomidine. Anesth Essays Res. 2013 Jan-Apr;7(1):65-70.
6. Joris JL, Noirot DP, Legrand MJ, Jacquet NJ, Lamy ML. Hemodynamic changes during laparoscopic cholecystectomy. Anesthesia & Analgesia. 1993 May 1;76(5):1067-71.
7. Wilcox S, Vandam LD. Alas, poor trendelenburg and his position!: A critique of its uses and effectiveness. Anesthesia & Analgesia. 1988 Jun 1;67(6):574-8.
8. Khan ZP, Munday IT, Jones RM, Thornton C, Mant TG, Amin D. Effects of dexmedetomidine on isoflurane requirements in healthy volunteers. 1: Pharmacodynamic and pharmacokinetic interactions. British journal of anaesthesia. 1999 Sep 1;83(3):372-80.
9. Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesthesia & Analgesia. 2000 Mar 1;90(3):699-705.
10. Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine: a review of clinical applications. Current Opinion in Anesthesiology. 2008 Aug 1;21(4):457-61.
11. Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology. 1992 Dec 1;77(6):1134-42.
12. Isik B, Arslan M, Özsoylar Ö, Akçabay M. The effects of α2-adrenergic receptor agonist dexmedetomidine on hemodynamic response in direct laryngoscopy. The open otorhinolaryngology journal. 2007 Nov 29;1(1).
13. Gurbet A, Basağan M, Türker G, Özcan B, Kaya EK, Uğun F. Intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements. Canadian Journal of Anaesthesia-Journal Canadien D. Anesthesie. 2006;53(7):646-52.
14. Sekimoto K, Nishikawa K, Ishizeki J, Kubo K, Saito S, Goto F. The effects of volatile anesthetics on intraoperative monitoring of myogenic motor-evoked potentials to transcranial electrical stimulation and on partial neuromuscular blockade during propofol/fentanyl/nitrous oxide anesthesia in humans. Journal of neurosurgical anesthesiology. 2006;18(2):106-11.
15. Poonai N, Spohn J, Vandermeer B, Ali S, Bhatt M, Hendrikx S, Trottier ED, Sabhaney V, Shah A, Joubert G, Hartling L. Intranasal Dexmedetomidine for Procedural Distress in Children: A Systematic Review. Pediatrics. 2020 Jan 1;145(1).
16. Grgurich P, Salah J, Nault K. 986: identification of risk factors for hypertension and tachycardia at dexmedetomidine discontinuation. Critical Care Medicine. 2020 Jan 1;48(1):472.
17. Atwan S, Hartner C, Edwin S, Paxton R. 1713: opportunities for the transition from dexmedetomidine to enteral clonidine. Critical Care Medicine. 2020 Jan 1;48(1):831.
18. Gbadamosi S, Morton J, Peters N. 928: predicting response to dexmedetomidine in mechanically ventilated intensive care unit patients. Critical Care Medicine. 2020 Jan 1;48(1):443.
19. Salman N, Uzun S, Coskun F, Salman MA, Salman AE, Aypar U. Dexmedetomidine as a substitute for remifentanil in ambulatory gynecologic laparoscopic surgery. Saudi medical journal. 2009;30(1):77-81.
20. Turgut N, Turkmen A, Ali A, Altan A. Remifentanil-propofol vs dexmedetomidine-propofol. Anesthesia for supratentorial cran-iotomy. MJE Anesth. 2009 Feb;20:63-70.
21. Smitha KS, Shukla D, Sathesha M, Rao NS, Sudheesh K. Comparison of two different doses of dexmedetomidine in attenuating hemodynamic changes during laryngoscopy. J Evol Med Dent Sci. 2014 Nov 13;3(61):13501-8.
22. Jarineshin H, Baghaei AA, Fekrat F, Kargar A, Abdi N, Navabipour S, Zare A, Akhlaghi H. Comparison of two different doses of dexmedetomidine in attenuating cardiovascular responses during laryngoscopy and endotracheal intubation: A double blind, randomized, clinical trial study. Journal of medicine and life. 2015;8(Spec Iss 4):45.
23. Park SH, Shin YD, Yu HJ, Bae JH, Yim KH. Comparison of two dosing schedules of intravenous dexmedetomidine in elderly patients during spinal anesthesia. Korean journal of anesthesiology. 2014 May;66(5):371.
24. Momeni MA, Elyasi H. The effect of 0.2 mic/kg Dexmedetomidine of post operative complication, acute pain and extubation time in patients under CABG, SBUMJ, 25(3):50-3.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Chethan P.L.
Postgraduate, Department of Anaesthesia, SIMS & RC Bangalore, Karnataka, India.
Dr. N.S. Shruthi
Assistant Professor, Department of Anaesthesia, SIMS & RC Bangalore, Karnataka, India.
Dr. Nikila Devarayasamudram Gopal
Associate professor, Department of Anaesthesia, SIMS & RC Bangalore, Karnataka, India.
Dr. Shobha Devendrappa Yavagal
Assistant Professor, Department of Anaesthesia, SIMS & RC Bangalore, Karnataka, India.