Analgesic Effect and Hemodynamic Changes Due to Dexmedetomidine Versus Fentanyl During Elective Colonoscopy: A Double-Blind Randomized Clinical Trial

Amri, Parviz; Nahrini, Sheyda; Hajian‐Tilaki, Karimollah; Hamidian, Mohammadtaghi; Alipour, Seyedeh Fatemeh; Hamidi, Seyed Hossein; Rajaei, Shima; Shokri‐Shirvani, Javad

doi:10.5812/aapm.81077

Cited by 21 publications

(33 citation statements)

References 17 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several pharmacological agents are developed to control hypotension, including remifentanil (3), magnesium sulphate (4), nitroglycerine (5), esmolol (5), and dexmedetomidine (5). The effect of dexmedetomidine on controlling hypotension is well known and is compared with other agents like remifentanil (3), magnesium sulphate (4), esmolol (5), clonidine (6), and fentanyl (7,8). Our institute has a history of providing FESS to normotensive patients under general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

To Compare the Efficacy of Dexmedetomidine Versus Labetalol in Providing Controlled Hypotension in Functional Endoscopic Sinus Surgery

Kumar

Vijay

2021

Anesth Pain Med

View full text Add to dashboard Cite

Background: Functional endoscopic sinus surgery (FESS) is a surgical intervention for sinus diseases. Bleeding is a common concern during FESS. Hemodynamic stability and quality surgical field visibility help to achieve the best outcomes. Objectives: The present study primarily intended to compare the effectiveness of dexmedetomidine versus labetalol in providing controlled hypotension during FESS and then to assess the quality of the surgical field. Methods: The current research was conducted as a prospective randomized double-blinded clinical study. Sixty patients of the American Society of Anesthesiologists grade I or II status undergoing FESS under general anesthesia were divided into two groups, each with 30 members. Patients receiving dexmedetomidine and labetalol were named as group D and L, respectively. The study intended to manage mean arterial pressure (MAP) between 65 - 75 mmHg. The visibility of the operative field was evaluated using Fromme and Boezaart scoring system. Total intraoperative fentanyl consumption and postoperative first analgesic request time were recorded. Results: The MAP target was achieved in both groups. Intergroup differences concerning MAP were observed in both D (75.0 ± 2.0) and L (82.4 ± 5.2) groups (P-value < 0.05). Scores for blood loss were significantly lower in the D group (1.3 ± 0.3) compared to the L group (2.1 ± 0.3) (P-value < 0.05). There was no intergroup difference concerning the mean heart rate (group D; 70.8 ± 4.2, and group L; 73.4 ± 4.4). The total dose of fentanyl consumed was found to be significantly lower in the group D (41.9 ± 5.8) compared to group L (59.9 ± 5.3) (P-value < 0.05). The first analgesic request time was significantly longer in the group D (50.2 ± 9.1) compared to group L (24.8 ± 5.1) (P-value < 0.05). Conclusions: Dexmedetomidine provided better hemodynamic stability and operative field visibility as compared to labetalol during FESS.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Although several clinical studies reported that dexmedetomidine can decrease hemodynamic responses and is associated with improved quality of surgical procedures of FESS, but we could not find a study on comparing dexmedetomidine with labetalol during FESS. Hence, we decided to perform such a comparison in our institute (3,7).…”

Section: Introductionmentioning

confidence: 99%

To Compare the Efficacy of Dexmedetomidine Versus Labetalol in Providing Controlled Hypotension in Functional Endoscopic Sinus Surgery

Kumar

Vijay

2021

Anesth Pain Med

View full text Add to dashboard Cite

show abstract

“…8 Unfortunately, intravenous infusion of dexmedetomidine may be accompanied by hypertension and bradycardia, which will endanger patient safety. 9,10 The problem of hypoxemia induced by propofol sedation has received more attention recently, but a general agreement in clinical practice is lacking.…”

Section: Introductionmentioning

confidence: 99%

<p>Application of Intravenous Lidocaine in Obese Patients Undergoing Painless Colonoscopy: A Prospective, Randomized, Double-Blind, Controlled Study</p>

Li¹,

Lv²,

Jiang³

et al. 2020

DDDT

View full text Add to dashboard Cite

Propofol for procedural sedation and analgesia (PSA) for colonoscopy can result in a high prevalence of severe respiratory depression. Studies have shown that intravenous (IV) infusion of lidocaine can reduce propofol requirements significantly and increase the ventilatory response to carbon dioxide in humans. We tested the hypothesis that IV lidocaine could improve propofol-induced respiratory depression in obese patients during colonoscopy. Methods: Ninety obese patients scheduled for painless colonoscopy were randomized to receive lidocaine (1.5 mg/kg, then 2 mg/kg/h, IV) or the same volume of 0.9% saline. Intraoperative sedation was provided by propofol. The primary outcome was the number of oxygen-desaturation episodes. Secondary outcomes were: the number of apnea episodes; total propofol consumption; time to the first hypoxia episode; time to consciousness loss; intraoperative hemodynamic parameters; awakening time; adverse events; duration of postanesthesia care unit (PACU) stay; satisfaction of endoscopists and patients. Results: Demographic characteristics between the two groups were comparable. The number of oxygen-desaturation episodes in group L (1.49±1.12) decreased by 0.622 (P=0.018) compared with that in group N (2.11±1.32), and the number of apnea episodes in group L decreased by 0.533 (P<0.001). Kaplan-Meier curves showed that the median time to the first hypoxia episode was longer in group L (86.78 s) than that in group N (63.83 s) (Log rank P=0.0008). The total propofol consumption, awakening time, and duration of PACU stay were reduced in group L. There was no significant difference in the prevalence of adverse events (P>0.05 for all). Satisfaction scores for endoscopists and patients in group L were higher than that in group N (P<0.001). Conclusion: Intravenous infusion of lidocaine could significantly reduce the number of oxygen-desaturation and apnea episodes in obese patients during painless colonoscopy. This method is worthy of clinical promotion. Clinical Trials Registration: ChiCTR2000028937.

show abstract

“…found that the intensity of pain was less in patients doing colonoscopy receiving dexmedetomidine than in other patients who received fentanyl. Dexmedetomidine resulted in a lower dose of rescue propofol when compared to the fentanyl group (17).…”

Section: Discussionmentioning

confidence: 83%

Comparative Effects of Total Intravenous Anesthesia with Propofol and Remifentanil Versus Inhalational Sevoflurane with Dexmedetomidine on Emergence Delirium in Children Undergoing Strabismus Surgery

Oriby

Elrashidy

2020

Anesth Pain Med

View full text Add to dashboard Cite

Background: Emergence delirium (ED) is common after strabismus surgery due to postoperative visual disturbance, vomiting, and pain. Total intravenous anesthesia (TIVA) has many advantages like smooth emergence from anesthesia, decreased incidence of postoperative nausea and vomiting (PONV), and postoperative analgesia. Objectives: Our study aimed to compare the incidence of ED using inhalational sevoflurane with dexmedetomidine (DEX) versus TIVA with remifentanil. Methods: Eighty-four patients aged 3 - 11 years scheduled for strabismus surgery under general anesthesia were randomly allocated into two groups. Patients in group I received sevoflurane and DEX (group I, n = 42), while group II patients received TIVA with propofol and remifentanil infusion (group II, n = 42). Mean arterial pressure (MAP), heart rate (HR), and pulse oximetry (SpO2) were monitored before induction, at induction, and every 10 minutes during the surgery. In the postanesthetic care unit (PACU), pediatric anesthesia emergence delirium (PAED), face, legs, activity, cry, and consolability (FLACC), need for rescue analgesics, recovery time, level of parents’ satisfaction, and PONV were recorded. Results: Based on the results, HR and MAP significantly decreased 10 and 20 min after induction compared to baseline in group I after infusion of DEX. The incidence of PONV was significantly lower in group II than in group I, while the recovery time was significantly shorter in group I. The incidence of emergence delirium decreased in both groups. Conclusions: The use of either total intravenous anesthesia with propofol and remifentanil or sevoflurane inhalational anesthesia with dexmedetomidine resulted in a lower incidence of emergence delirium, although dexmedetomidine resulted in hypotension, bradycardia, and PONV.

show abstract

Analgesic Effect and Hemodynamic Changes Due to Dexmedetomidine Versus Fentanyl During Elective Colonoscopy: A Double-Blind Randomized Clinical Trial

Cited by 21 publications

References 17 publications

To Compare the Efficacy of Dexmedetomidine Versus Labetalol in Providing Controlled Hypotension in Functional Endoscopic Sinus Surgery

To Compare the Efficacy of Dexmedetomidine Versus Labetalol in Providing Controlled Hypotension in Functional Endoscopic Sinus Surgery

<p>Application of Intravenous Lidocaine in Obese Patients Undergoing Painless Colonoscopy: A Prospective, Randomized, Double-Blind, Controlled Study</p>

Comparative Effects of Total Intravenous Anesthesia with Propofol and Remifentanil Versus Inhalational Sevoflurane with Dexmedetomidine on Emergence Delirium in Children Undergoing Strabismus Surgery

Contact Info

Product

Resources

About