Efficacy of dexmedetomidine in attenuating pressor response to laryngoscopy and endotracheal intubation under bispectral index controlled anesthesia: a prospective randomized double-blinded study
Tóm tắt
Laryngoscopy and endotracheal intubation may lead to a remarkable hemodynamic pressor response. Dexmedetomidine, an α2-adrenergic receptor agonist, can be effectively used to attenuate this pressor effect. This study was aimed to compare the efficacy of two different doses of dexmedetomidine (0.5 µg/kg and 1.0 µg/kg) in attenuation of hemodynamic pressor response to largyngoscopy and endotracheal intubation under bispectral index (BIS) monitoring. One hundred twenty adult patients with American Society of Anesthesiologists (ASA) physical status I or II posted for various elective surgeries under general anesthesia were enrolled to receive an intravenous (IV) infusion of dexmedetomidine 0.5 μg/kg (group D1;
The mean HR, SBP, DBP, and MAP remained significantly lower in both dexmedetomidine groups as compared to control group after study drug infusion, after induction, at and after intubation (
Dexmedetomidine (0.5 µg/kg and 1.0 µg/kg) was found to be effective in attenuating the hemodynamic pressor response to laryngoscopy and endotracheal intubation with BIS monitoring.
CTRI,
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Tài liệu tham khảo
Aleem MA, Awati MN, Adarsh S (2012) Attenuation of cardiovascular responses to direct laryngoscopy and intubation - a comparative study between iv bolus fentanyl, lignocaine and placebo (NS). J Clin Diagn Res 6:1749–52
Bajwa SS, Kaur J, Singh A, Parmar SS, Singh G, Kulshrestha A, Gupta S, Sharma V, Panda A (2012) Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine. Indian J Anaesth 56:123–8
Dutta A, Sethi N, Sood J, Panday BC, Gupta M, Choudhary P, Puri GD (2019) The Effect of dexmedetomidine on propofol requirements during anesthesia administered by bispectral index-guided closed-loop anesthesia delivery system: a randomized controlled study. Anesth Analg 129:84–91
Ganesan P, Balachander H, Elakkumanan LB (2020) Evaluation of nebulized lignocaine versus intravenous lignocaine for attenuation of pressor response to laryngoscopy and intubation. Curr Med Issues 18:184–8
Gu X, Tan X, Chen J et al (2020) The clinical effect of dexmedetomidine combined with parecoxib sodium on sedation, antianxiety and prevention of intubation stress in patients undergoing functional endoscopic sinus surgery: a randomised controlled trial. BMC Anesthesiol 20:166
Gupta K, Bansal M, Gupta PK, Singh M, Agarwal S, Tiwari V (2016) Dexmedetomidine premedication with three different dosages to attenuate the adverse hemodynamic responses of direct laryngoscopy and intubation: a comparative evaluation. Ain-Shams J Anaesthesiol 9:66–71
Haidry MA, Khan FA (2013) Comparison of hemodynamic response to tracheal intubation with Macintosh and McCoy laryngoscopes. J Anaesthesiol Clin Pharmacol 29:196–9
Hosalli V, Adarsh ES, Hulkund SY, Joshi C (2014) Comparative efficacy of different doses of fentanyl on cardiovascular responses to laryngoscopy and tracheal intubation. J Clin Diagn Res 8:GC01-03
Joffe AM, Deem SA (2013) Physiologic and pathophysiologic responses to intubation. In: Benumof J, Hagberg CA (eds) Benumof and Hagberg’s Airway Management, 3rd edn. Elsevier Saunders, Philadelphia, pp 184–98
Kelley SD (2010) Monitoring consciousness using the Bispectral Index during anesthesia, 2nd edn. Covidien, Boulder
Keniya VM, Ladi S, Naphade R (2011) Dexmedetomidine attenuates sympathoadrenal response to tracheal intubation and reduces perioperative anaesthetic requirement. Indian J Anaesth 55:352–7
Lee CW, Kim M (2017) Effects of preanesthetic dexmedetomidine on hemodynamic responses to endotracheal intubation in elderly patients undergoing treatment for hypertension: a randomized, double-blinded trial. Korean J Anesthesiol 70:39–45
Mahajan L, Kaur M, Gupta R, Aujla KS, Singh A, Kaur A (2018) Attenuation of the pressor responses to laryngoscopy and endotracheal intubation with intravenous dexmedetomidine versus magnesium sulphate under bispectral index-controlled anaesthesia: a placebo-controlled prospective randomised trial. Indian J Anaesth 62:337–43
Saghaei M, Masoodifar M (2001) The pressor response and airway effects of cricoid pressure during induction of general anesthesia. Anesth Analg 93:787–90
Sharma S, Suthar OP, Tak ML, Thanvi A, Paliwal N, Karnawat R (2018) Comparison of esmolol and dexmedetomidine for suppression of hemodynamic response to laryngoscopy and endotracheal intubation in adult patients undergoing elective general surgery: a prospective, randomized controlled double-blinded study. Anesth Essays Res 12:262–66
Shribman AJ, Smith G, Achola KJ (1987) Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth 59:295–9
Tanskanen PE, Kyttä JV, Randell TT, Aantaa RE (2006) Dexmedetomidine as an anaesthetic adjuvant in patients undergoing intracranial tumour surgery: a double-blind, randomized and placebo-controlled study. Br J Anaesth 97:658–65
Xing Lu, Jin Xin, Yang Suwei, Xia Yanfei (2018) The correlation of the depth of anesthesia and postoperative cognitive impairment: A meta-analysis based on randomized controlled trials. J Clin Anesth 45:55–9
Zbinden AM, Petersen-Felix S, Thomson DA (1994) Anesthetic depth defined using multiple noxious stimuli during isoflurane/oxygen anesthesia: II. Hemodynamic responses. Anesthesiology 80:261–7