Comparison of dexmedetomidine, lidocaine, and their combination in attenuation of cardiovascular and catecholamine responses to tracheal extubation and anesthesia emergence in hypertensive patients

Moustafa, Ashraf M.; Atalla, Hatem A; Koptan, Hala M

doi:10.4103/2356-9115.161307

Cited by 5 publications

(4 citation statements)

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“…In contrast to our study, another previous study showed that Intravenous dexmedetomidine did not effectively reduce straining or coughing associated with extubation compared with lidocaine and that was because of using a different methodology in that previous study which was using a higher intravenous lidocaine dose of 2 mg/kg, also another timing which was 1 min before extubation and a different population including both children and adults (21) . Also Contrary to our study, in a previous study lidocaine combined with dexamethasone did not reduce the incidence of postoperative cough compared with dexamethasone alone.…”

Section: Discussioncontrasting

confidence: 99%

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Pharmacological Methods to Decrease Coughing on Emergence Following General Anesthesia With Tracheal Intubation in Lower Abdominal Surgeries

Shady

Kamaly

Hakim

et al. 2021

Ain Shams Medical Journal

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Background: Emergence from anesthesia and extubation induces variant physiological responses including unwanted circulatory and airway reflexes resulting in hyper circulatory manifestations in the form of tachycardia, hypertension, cough, laryngospasm, and bronchospasm. These events may predispose or induce multiple complications either in the operative site or elsewhere in the body. Aim of the Work:To explore various pharmacological perioperative techniques that can be used to achieve a smooth extubation while caring for an uncomplicated patient without significant risk factors for extubation failure. Patients and Methods:Randomized sample for population who were admitted for lower abdominal surgery under general anesthesia with oral endotracheal intubation in Ain-Shams University Hospitals after Ethical Committee approval and starting from January 2021. Results:There is clinical evidence to support the use of Dexmedetomidine, Lidocaine and Dexamethsaone to significantly attenuate excessive coughing, hemodynamic shifts, postoperative sedation and prolongation of time during extubation. Patients" characteristics (age and sex), duration of surgery, type of surgery and Oxygen Saturation show non-significant difference between the four groups. Conclusion:The quality of tracheal extubation was better in Dexmedetomidine, Lidocaine and Dexamethasone groups over control group with Dexmedetomidine group being the most favorable in patients requiring General anesthesia with endotracheal intubation for lower abdominal surgeries, without any adverse effects.

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Section: Discussioncontrasting

confidence: 99%

“…In addition, lidocaine may act centrally to increase the depth of anesthesia. The valuable effect of lidocaine on suppressing the hemodynamic perturbations to extubation may be because of its direct cardiac depression and peripheral vasodilatation as it could significantly depress all excitable membranes including the heart (21) .…”

Section: Discussionmentioning

confidence: 99%

Pharmacological Methods to Decrease Coughing on Emergence Following General Anesthesia With Tracheal Intubation in Lower Abdominal Surgeries

Shady

Kamaly

Hakim

et al. 2021

Ain Shams Medical Journal

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“…Lidocaine on the other hand suppresses the cough reflex due to tracheal extubation by its effect on synaptic transmission and attenuates the hemodynamic response by its peripheral vasodilatory effect, direct myocardial depressant effect, and central stimulant effect [4]. After reviewing through the available literature, we could not find any reliable method or technique for smooth, cough-free extubation.…”

Section: Introductionmentioning

confidence: 93%

“…Various drug regimens and techniques have been used from time to time to attenuate these responses during extubation such as the use of laryngeal mask airway during emergence, extubation in deep plane of anesthesia, use of drugs such as intravenous dexmedetomidine, intravenous lignocaine, and short-acting opioids such as intravenous fentanyl, remifentanil, and esmolol in the past [3]. Dexmedetomidine is a new alpha-2 agonist that decreases circulating catecholamines with a slight decrease in blood pressure and modest reduction in heart rate (HR) [4].…”

Section: Introductionmentioning

confidence: 99%

Effects of Intravenous Lidocaine Versus Dexmedetomidine on Attenuation of Cough During Tracheal Extubation After Elective Surgery: A Comparative Double-Blind Study

AKSHITA SINGLA,

POOJA MONGIA,

MANGILAL DEGANWA

et al. 2024

Asian J Pharm Clin Res

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Objective: The objective of the study is to compare the effects of intravenous lidocaine and dexmedetomidine in attenuating cough during tracheal extubation after elective surgery. Methods: Study conducted on 100 patients aged 18–65 years at Mahatma Gandhi University of Medical Sciences and Technology from August 2020 to July 2021. Patients with elective surgeries under general anesthesia with endotracheal intubation, age 18–65 years, both the sexes, American Society of Anesthesiologists, grade I and II were included in the study. Results: Both lidocaine and dexmedetomidine are equally effective in cough attenuation on tracheal extubation. The hemodynamic stability was much better with dexmedetomidine compared to lidocaine at all times. Lidocaine group patients were ready to discharge from post-anesthesia care unit statistically earlier than the dexmedetomidine group. Conclusion: Both lidocaine and dexmedetomidine are safe and reliable drugs which provide very effective attenuation of cough during tracheal extubation without any respiratory depressant effect.

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Effect of Dexmedetomidine on Haemodynamic and Recovery Responses During Tracheal Extubation: A Randomized Comparative Study

Vankayalapati¹,

Ramsali²,

Dumpala³

et al. 2016

jemds

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This study was undertaken to evaluate the effect of a bolus dose of dexmedetomidine on haemodynamic, recovery responses and airway reflexes during extubation. MATERIAL AND METHODSSixty patients aged 20-45 yrs. of either sex of ASA grade I/II scheduled for elective general surgical, ENT, orthopaedics and gynaecological surgeries were studied after randomisation into two groups; 5 minutes before anticipated end of surgery, group A and B received either dexmedetomidine 0.5 µg/kg or placebo (Saline) respectively intravenously over 2 minutes. Anaesthesia technique was standardised for both groups. Heart rate, systolic, diastolic, mean arterial pressures were recorded at the start of a bolus drug injection and thereafter 1, 2 and 3 minutes after injection during extubation; at 1, 3, 5 minutes after extubation for 15 minutes. Quality of extubation was evaluated immediately after extubation based on cough using a 5-point rating score. Postoperative sedation was evaluated on a 6-point scale (Ramsay sedation scale). Side effects like laryngospasm, bronchospasm, respiratory depression, desaturation, vomiting, hypotension, bradycardia and undue sedation were noted. RESULTSHeart rate, systolic, diastolic, mean arterial pressure were significantly lower in study group. Extubation quality score in majority of cases was score 1 in study group and score 3 in control group. Sedation score in most of the cases was 3 in study group and 2 in control group. Bradycardia and hypotension were more in study group. Vomiting incidence was comparable in both the groups. CONCLUSIONOur study concludes that single dose of dexmedetomidine 0.5 µg/kg administered 5 minutes before extubation attenuates the haemodynamic and airway reflexes during emergence from anaesthesia without causing undue sedation. KEYWORDSDexmedetomidine, Haemodynamic Responses, Airway Reflexes, Extubation. HOW TO CITE THIS ARTICLE:Vankayalapati SD, Ramsali MV, Dumpala S, et al. Effect of dexmedetomidine on haemodynamic and recovery responses during tracheal extubation: a randomized comparative study.

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Comparison of dexmedetomidine, lidocaine, and their combination in attenuation of cardiovascular and catecholamine responses to tracheal extubation and anesthesia emergence in hypertensive patients

Cited by 5 publications

References 0 publications

Pharmacological Methods to Decrease Coughing on Emergence Following General Anesthesia With Tracheal Intubation in Lower Abdominal Surgeries

Pharmacological Methods to Decrease Coughing on Emergence Following General Anesthesia With Tracheal Intubation in Lower Abdominal Surgeries

Effects of Intravenous Lidocaine Versus Dexmedetomidine on Attenuation of Cough During Tracheal Extubation After Elective Surgery: A Comparative Double-Blind Study

Effect of Dexmedetomidine on Haemodynamic and Recovery Responses During Tracheal Extubation: A Randomized Comparative Study

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