The comparison of the effects of dexmedetomidine, fentanyl and esmolol on prevention of hemodynamic response to intubation

Göğüş, Nermin; Akan, Belgin; Serger, Nurten; Baydar, Mustafa

doi:10.1016/j.bjane.2013.10.012

Cited by 22 publications

(13 citation statements)

References 16 publications

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“…12,13 Similarly sympathoadrenal response parameters have been studied at dose of 1 μg /kg by other researchers like Panda BK et al, Gonus N et al, Keniya V et al, Laha A et al and inferred that perioperative use of dexmedetomidine is effective in attenuating sympathoadrenal response to tracheal intubation and has a significant anaesthetic and opioid sparing effect. 11,13,14,15 Similar to our study in group B, Laha A et al observed a statistically significant transient fall in mean HR with 1µg/kg of infusion of dexmedetomidine over 10 minutes. 13 In our study at completion of drug infusion (T4) in group B the mean HR falls to 27.2% from the baseline value, which is transient and it was followed by fall in mean HR by 16.2% after induction.…”

Section: Discussionsupporting

confidence: 83%

“…Transient bradycardia was observed by Gogus N et al also in their study using infusion of dexmedetomidine at 1 µg/kg over 10 minutes prior to induction. 15 Significant transient fall in HR at 1st and 5th minute after administration of single dose of 2µg /kg was observed by Lowrence et al, 16 Kenya V et al have shown decrease in HR after the infusion of 1 μg /kg of dexmedetomidine. 11…”

Section: Discussionmentioning

confidence: 90%

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Two Different Doses of Dexmedetomidine in Attenuating Sympathoadrenal Response to Endotracheal Intubation - A Comparative Study

Chandrashekharan¹,

Pullat²

2018

jebmh

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BACKGROUND The objective of our study was to determine whether a lower dose (0.6 microgram/kg) of dexmedetomidine is as effective as the usual dose (1 microgram/kg) for attenuating sympathoadrenal response to endotracheal intubation. MATERIALS AND METHODS 90 patients were fixed to undergo elective surgeries under general anaesthesia, were randomly divided into 3 groups. Group Areceived 0.6 microgram/kg of dexmedetomidine, group B received 1 microgram/kg of dexmedetomidine and group C received 10 ml normal saline over 10 minutes before induction. Anaesthesia was standardised in the groups and vital parameters were recorded for up to 10 minutes after intubation. RESULTS At 5 minutes and completion of drug infusion, group B had statistically significant fall in heart rate as compared to group A (17.3% and 27.2% vs. 5.2% and 10.3%). Maximum fall in mean heart rate was observed at 10 minutes after intubation in group A (29.1%) and at completion of drug infusion in group B (27.2%). The maximum fall in SBP in both groups was observed at 10 minutes following intubation, Group C had statistically significant higher values of HR, SBP, DBP, MAP during all time interval following ET intubation. CONCLUSION A lower dose of dexmedetomidine (0.6 microgram/kg) loading dose provides, significantly better attenuation of sympathoadrenal response to endotracheal intubation unaccompanied by transient increase in blood pressure and bradycardia, which is observed at higher dose of dexmedetomidine (1 microgram/kg) loading dose.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 90%

Two Different Doses of Dexmedetomidine in Attenuating Sympathoadrenal Response to Endotracheal Intubation - A Comparative Study

Chandrashekharan¹,

Pullat²

2018

jebmh

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“…Gogus et al [16], compared between the effects of use of fentanyl, dexmedetomidine and esmolol on prevention of hemodynamic response to intubation in 90 patients undergoing elective surgery and who were in ASA I or II and between 21-65 years, and they concluded that esmolol was more effective than dexmedetomidine and fentanyl in prevention of the increases in systolic, diastolic and mean arterial pressures following endotracheal intubation. On the other hand, dexmedetomidine was more effective than esmolol and fentanyl in preventing the increase in heart rate.…”

Section: Discussionmentioning

confidence: 99%

Study of the Effect of Dexmedetomidine in Reducing Hemodynamic Responses to General Anesthesia for Elective Cesarean Section in Patients with Preeclampsia

Mahrous¹

2015

J Anesth Clin Res

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Background: Depending on the effect of dexmedetomidine in haemodynamic stability, it was started to be used as a sedative prior to and/or during surgical and other procedures in non-intubated adult and pediatric patients. In 2009, dexmedetomidine has been successfully used in laboring parturients. It provides maternal hemodynamic stability, anxiolysis, and stimulation of uterine contractions. Literature describes that dexmedetomidine has a high placental retention and does not cross the placenta, with less incidence of fetal bradycardia. We hypothesized that dexmamedetomidine would be effective in reducing the maternal hemodynamic responses to elective cesarean section in preeclmaptic patients without adverse neonatal effects.

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“…[14][15][16][17] Its effectiveness in obtunding the pressor response during intubation has also been compared with other drugs and placebos and found to be more effective than these drugs. [18][19][20][21][22][23][24][25] Dexmedetomidine has been used in different doses in infusion form with or without bolus doses. Some researchers found that Dexmedetomidine given in the dose of 0.25-0.5 µg/Kg body weight only decreased blood pressure while doses of 1-2 µg/Kg was associated with transient increase in blood pressure followed by hypotension and bradycardia with, maximum fall in heart occurred with the dose of 2 µg/Kg body weight.…”

Section: Discussionmentioning

confidence: 99%

“…and found that it is superior to these drugs in obtunding the hemodynamic changes during intubation. [18][19][20][21][22][23][24][25] Effects of different doses of dexmedetomidine on intubation response have also been studied. Dexmedetomidine in the doses of 0.5 µg/Kg body wt.…”

mentioning

confidence: 99%

Haemodynamic Responses to Laryngoscopy and Endotracheal Intubation After Intravenous Dexmedetomidine: A Comparison Between Two Doses

Dhanachandra¹,

Singh²

2019

jebmh

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BACKGROUND Many pharmacological drugs are used to attenuate the haemodynamic response to laryngoscopy and endotracheal intubation. Dexmedetomidine, a highly selective α2 agonist has pharmacological properties like sedation, sympatholysis, analgesic property and less respiratory depression with preservation of the ventilator response to carbon dioxide and makes it an ideal adjuvant drug during general anaesthesia, in comparison to other drugs. In this study we compared the effects of two different doses of Dexmedetomidine on the haemodynamic responses during laryngoscopy and endotracheal intubation. MATERIALS AND METHODS Ninety patients of American society of anesthesiologists (ASA) physical grades I and II undergoing general anaesthesia were randomly allocated into three groups of 30 patients each. Values of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP) were recorded before giving the drug. Group A, Group B and Group C received 20 ml of Inj. Normal Saline, Inj. Dexmedetomidine 0.5 µg/Kg diluted to 20 ml with normal saline and dexmedetomidine 0.75 µg/Kg body weight diluted to 20 ml normal saline respectively as infusion over 10 minutes. Sedation scores were also recorded 1 min and 3 min after giving the test drugs. HR, SBP, DBP, MAP were recorded 1 min, 3 min, 5min, and 10 minutes after laryngoscopy and intubation. RESULTS The increase in HR, SBP, DBP and MAP after intubation were significantly less in Group C than Group A and Group and B and lasted longer than Group A and Group B. Sedation score was significantly low in Group C than Group A and Group B CONCLUSION Both the doses of Intravenous dexmedetomidine 0.5 µg/Kg body weight and 0.75 µg/Kg body weight attenuate the haemodynamic response of laryngoscopy and endotracheal intubation, but the dose of 0.75 µg/Kg body was found to be more effective than 0.5 µg/Kg body weight.

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The comparison of the effects of dexmedetomidine, fentanyl and esmolol on prevention of hemodynamic response to intubation

Cited by 22 publications

References 16 publications

Two Different Doses of Dexmedetomidine in Attenuating Sympathoadrenal Response to Endotracheal Intubation - A Comparative Study

Two Different Doses of Dexmedetomidine in Attenuating Sympathoadrenal Response to Endotracheal Intubation - A Comparative Study

Study of the Effect of Dexmedetomidine in Reducing Hemodynamic Responses to General Anesthesia for Elective Cesarean Section in Patients with Preeclampsia

Haemodynamic Responses to Laryngoscopy and Endotracheal Intubation After Intravenous Dexmedetomidine: A Comparison Between Two Doses

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