A Comparison of the Effects of Dexmedetomidine and Propofol in Controlling the Hemodynamic Responses after Intubation: A Double-Blind, Randomized, Clinical Trial Study

Kamali, Alireza; Taghizadeh, Mehrdad; Esfandiar, Mohtaram; Akhtari, Amin Shams

doi:10.3889/oamjms.2018.385

Cited by 8 publications

(8 citation statements)

References 19 publications

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“…In their study the dose of fentanyl used was 1 µg/kg whereas we used it in higher dose that is 2 µg/kg which might be the reason for the difference in the result of our study. Alireza et al 23 compared dexmedetomidine and propofol in controlling the hemodynamic response following intubation in the patients in the emergency department. They used dexmedetomidine in a dose of 0.4 µg/kg.…”

Section: Similarlymentioning

confidence: 99%

A Comparative Study between Two Different Doses of Dexmedetomidine for Attenuation of Hemodynamic Response to Laryngoscopy and Tracheal Intubation.

Thapa

Gauchan

2019

Nep. Med. Coll. J.

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Laryngoscopy and end tracheal intubation are stressful situation for the patients, as these procedures are capable of producing tachycardia, hypertension and arrhythmias. This study was conducted with the objective of arriving at an optimal dose of dexmedetomidine that can attenuate the hemodynamic response to laryngoscopy and intubation with minimal side effects. The current study was conducted in 60 patients, posted for elective surgery under general anesthesia withendotracheal intubation. The patients were divided into two groups: Group A and Group B. Group A received dexmedetomidine 0.5 μg/kg and group B received dexmedetomidine 1 μg/kg intravenously over 10 min prior to induction of anesthesia. The anesthesia technique was standardized in both the groups. Heart rate, systolic, diastolic and mean arterial pressure were monitored and recorded at 5min and 10 min of completion of infusion of study drug, after induction, and at 1 min, 2 min, 5 min after intubation. The baseline heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were statistically similar in both the groups. After the infusion of the study drug the mean heart rate, mean systolic blood pressure, mean diastolic blood pressure, mean arterial pressure at all times were comparable in both the groups. Episodes of hypotension and bradycardia were also statistically similar in both the groups. Attenuation of hemodynamic response to laryngoscopy and intubation by dexmedetomidine is similar with the two doses: 0.5 μg/kg and 1 μg/kg. Both the doses of dexmedetomidine were devoid of any significant adverse effects.

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Section: Similarlymentioning

confidence: 99%

A Comparative Study between Two Different Doses of Dexmedetomidine for Attenuation of Hemodynamic Response to Laryngoscopy and Tracheal Intubation.

Thapa

Gauchan

2019

Nep. Med. Coll. J.

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“…In surgical application, dexmedetomidine is administered to maintain the balance of hemodynamic factors and provide effective analgesia; this helps reduce the use of anesthetics [ 1 , 2 ]. For patients with endotracheal intubation under general anesthesia, it can maintain hemodynamic stability, facilitate intraoperative management, and reduce the occurrence of serious cardiac accidents, including myocardial ischemia in surgical patients with cardiovascular disease [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Dexmedetomidine on Perioperative Hemodynamics and Myocardial Protection in Thoracoscopic-Assisted Thoracic Surgery

Shi

2021

Med Sci Monit

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Background This study aimed to clarify the protective role of dexmedetomidine in thoracoscopic-assisted thoracic surgery (TATS), including control of the intraoperative heart rate, blood pressure, and myocardial injury markers. Material/Methods The patients who underwent TATS were divided into 2 equal groups: the dexmedetomidine group (dexmedetomidine pumped at 0.5 μg/kg for >10 min before the administration of anesthesia and at 0.5 μg/kg in the maintenance period) and the control group (pumped normal saline for >10 min before the administration of anesthesia). The data recorded for each patient were heart rate (preoperative, maximum intraoperative, and minimum intraoperative), systolic and diastolic blood pressure, intraoperative hemodynamic data, and intraoperative cardiovascular drugs administered. An enzyme-linked immunosorbent assay was performed to assess the postoperative levels of cardiac troponin I (cTnI), creatine kinase isoenzyme, myoglobin, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Results There were no significant differences in the age, sex, body height, body weight, American Society of Anesthesiologists classification grade, resection mode, operation time, ejection fraction, basal heart rate, and systolic and diastolic blood pressure of the 2 groups. In the dexmedetomidine group, the patients’ maximum intraoperative heart rate and diastolic pressure decreased, and the postoperative hospital stay period was shorter. The postoperative peripheral blood test for the dexmedetomidine group showed higher NT-proBNP levels and lower cTnI levels. Conclusions Preoperative administration of dexmedetomidine can benefit hemodynamic stability, protect the cardiovascular system in the intraoperative and postoperative periods, and shorten postoperative hospitalization.

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“…This could suggest our primary endpoint of 30 minutes from infusion was not optimal, despite previous reports. 9,10…”

Section: Discussionmentioning

confidence: 99%

“…Several studies evaluated hemodynamic effects of propofol in non-TTM patients and found hypotension was seen within 30 minutes of propofol introduction. 9,10 During TTM drug distribution may be limited and metabolism and excretion may be decreased, thus perpetuating drug effects in an unpredictable manner. 11 These alterations have been attributed to drug distribution to central and peripheral compartments and reduction in hepatic blood flow.…”

Section: Introductionmentioning

confidence: 99%

Effects of Propofol on Hemodynamic Profile in Adults Receiving Targeted Temperature Management

et al. 2021

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Background: Propofol is a key component for the management of sedation and shivering during targeted temperature management (TTM) following cardiac arrest. The cardiac depressant effects of propofol have not been described during TTM and may be especially relevant given the stress to the myocardium following cardiac arrest. The purpose of this study is to describe hemodynamic changes associated with propofol administration during TTM. Methods: This single center, retrospective cohort study evaluated adult patients who received a propofol infusion for at least 30 minutes during TTM. The primary outcome was the change in cardiovascular Sequential Organ Failure Assessment (cvSOFA) score 30 minutes after propofol initiation. Secondary outcomes included change in systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate (HR), and vasopressor requirements (VR) expressed as norepinephrine equivalents at 30, 60, 120, 180, and 240 minutes after propofol initiation. A multivariate regression was performed to assess the influence of propofol and body temperature on MAP, while controlling for vasopressor dose and cardiac arrest hospital prognosis (CAHP) score. Results: The cohort included 40 patients with a median CAHP score of 197. The goal temperature of 33°C was achieved for all patients. The median cvSOFA score was 1 at baseline and 0.5 at 30 minutes, with a non-significant change after propofol initiation ( P = .96). SBP and MAP reductions were the greatest at 60 minutes (17 and 8 mmHg; P < .05 for both). The median change in HR at 120 minutes was −9 beats/minute from baseline. This reduction was sustained through 240 minutes ( P < .05). No change in VR were seen at any time point. In multivariate regression, body temperature was the only characteristic independently associated with changes in MAP (coefficient 4.95, 95% CI 1.6-8.3). Conclusion: Administration of propofol during TTM did not affect cvSOFA score. The reductions in SBP, MAP, and HR did not have a corresponding change in vasopressor requirements and are likely not clinically meaningful. Propofol appears to be a safe choice for sedation in patients receiving targeted temperature management after cardiac arrest.

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A Comparison of the Effects of Dexmedetomidine and Propofol in Controlling the Hemodynamic Responses after Intubation: A Double-Blind, Randomized, Clinical Trial Study

Cited by 8 publications

References 19 publications

A Comparative Study between Two Different Doses of Dexmedetomidine for Attenuation of Hemodynamic Response to Laryngoscopy and Tracheal Intubation.

A Comparative Study between Two Different Doses of Dexmedetomidine for Attenuation of Hemodynamic Response to Laryngoscopy and Tracheal Intubation.

Effect of Dexmedetomidine on Perioperative Hemodynamics and Myocardial Protection in Thoracoscopic-Assisted Thoracic Surgery

Effects of Propofol on Hemodynamic Profile in Adults Receiving Targeted Temperature Management

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