Influence of Dexmedetomidine on the Tourniquet Related Responses in Hypertension Patients Receiving Unilateral Knee Arthroplasty under General Anesthesia

Li, Yonghua; Wang, Yongqiang; Zhang, Yijie; Zheng, Dongyu; Hu, Liu; Tian, Mou-Li

doi:10.1016/j.arth.2015.02.034

Cited by 8 publications

(7 citation statements)

References 14 publications

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“…In other studies, Dex administration could reduce the serum CK levels during limb extremity surgery. 22,23 However, the CK levels in our study showed a declining trend in the Dex group compared with the Control group, but there was no statistically significant difference.…”

Section: Discussioncontrasting

confidence: 60%

Effects of dexmedetomidine on the function of distal organs and oxidative stress after lower limb ischaemia–reperfusion in elderly patients undergoing unilateral knee arthroplasty

Chen

et al. 2021

Brit J Clinical Pharma

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This study aims to evaluate the effects of dexmedetomidine on organ function, inflammation response, and oxidative stress in elderly patients following iatrogenic lower limb ischaemia-reperfusion (IR) during unilateral total knee arthroplasty.Methods: Following unilateral total knee arthroplasty, 54 elderly patients were randomized to receive either intraoperative intravenous injection of dexmedetomidine (n = 27) or equivalent volume of 0.9% saline (n = 27). Blood samples were harvested at 5 minutes before lower limb tourniquet release (baseline); and 1, 6 and 24 hours after tourniquet release. Surrogate markers of cardiac, pulmonary, hepatic and renal function, oxidative stress, inflammatory response, along with parasympathetic and sympathetic activity were recorded and analysed.Results: The levels of blood xanthine oxidase, creatine kinase, lactic acid and respiratory index increased in patients following tourniquet-induced lower limb IR injury.

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Section: Discussioncontrasting

confidence: 60%

Effects of dexmedetomidine on the function of distal organs and oxidative stress after lower limb ischaemia–reperfusion in elderly patients undergoing unilateral knee arthroplasty

Chen

et al. 2021

Brit J Clinical Pharma

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“…Meta-analysis of respiratory index Two trials including 140 patients reported the respiratory index (30,32). The pooled data showed no signi cant difference between the dexmedetomidine group and the placebo group (MD: -0.07; 95% CI: from -0.31 to 0.18; p=0.60).…”

Section: Results Of Meta-analysismentioning

confidence: 99%

“…After searching the database and comparing the present criteria, a total of 17 trials were included in the meta-analysis (16,19,20,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). These trials are all randomized control trials.…”

Section: Selection Of Trialsmentioning

confidence: 99%

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Effect of dexmedetomidine on lung function and prognosis a systematic review and meta-analysis

Chen

Yang

Sun

et al. 2020

Preprint

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Background: This systematic review and meta-analysis aimed to evaluate the effect of dexmedetomidine on lung function and prognosis.Methods: We searched PubMed, Embase and the Cochrane Library from inception to January 30, 2020 following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement guidelines. Randomized controlled trials of dexmedetomidine associated with lung function were assessed. The primary outcomes are pH, PaO2, PaCO2, respiratory index (RI) and time to extubation. The secondary outcomes are PaO2/FiO2, length of hospital stay and events of pulmonary complications.Results: 17 trials of 924 patients were included. Compared with placebo group, dexmedetomidine group had higher PaO2 (MD: 10.96; 95% CI: from 0.77 to 21.15; p=0.04) and PaO2/FiO2 (MD: 30.77; 95% CI: from 19.11 to 42.43; p<0.00001). The dexmedetomidine group had lower PaCO2 (MD: -0.88; 95% CI: from -1.66 to -0.11; p=0.002) and shorter length of hospital stay (MD: -1.19; 95% CI: from -2.21 to -0.16; p=0.02). The dexmedetomidine group had lower occurrence of pulmonary complications (RR: 0.28; 95% CI: from 0.09 to 0.82; p=0.02). However, there is no significant difference in pH, respiratory index and extubation time.Conclusion: Dexmedetomidine has better influence on lung function and prognosis.

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“…TIH is also associated with sympathetic nervous system activation [9]. Various methods have been used to prevent TIH during surgery [10][11][12][13]. Several studies have assessed ketamine, a pain-regulating drug, as an NMDA receptor antagonist, which effectively reduced the development of TIH when pre-administered at small doses or more [11,14,15].…”

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confidence: 99%

Comparison of bolus administration effects of lidocaine on preventing tourniquet-induced hypertension in patients undergoing general anesthesia: a randomized controlled trial

et al. 2022

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Background: This study assessed the effect of a single bolus administration of lidocaine on the prevention of tourniquet-induced hypertension (TIH) and compared the effect of lidocaine to that of ketamine in patients undergoing general anesthesia.Methods: This randomized, controlled, double-blind study included 75 patients who underwent lower limb surgery using a tourniquet. The patients were administered lidocaine (1.5 mg/kg, n = 25), ketamine (0.2 mg/kg, n = 25) or placebo (n = 25). The study drugs were administered intravenously 10 min before tourniquet inflation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured before tourniquet inflation, after tourniquet inflation for 60 min at 10 min intervals, and immediately after tourniquet deflation. The incidence of TIH, defined as an increase of 30% or more in SBP or DBP during tourniquet inflation, was also recorded.Results: SBP, DBP, and HR increased significantly over time in the control group compared to those in the lidocaine and ketamine groups for 60 min after tourniquet inflation (P < 0.001, P < 0.001, and P = 0.007, respectively). The incidence of TIH was significantly lower in the lidocaine (n = 4, 16%) and ketamine (n = 3, 12%) group than in the control group (n = 14, 56%) (P = 0.001). Conclusion: Single-bolus lidocaine effectively attenuated blood pressure increase due to tourniquet inflation, with an effect comparable to that of bolus ketamine.

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Influence of Dexmedetomidine on the Tourniquet Related Responses in Hypertension Patients Receiving Unilateral Knee Arthroplasty under General Anesthesia

Cited by 8 publications

References 14 publications

Effects of dexmedetomidine on the function of distal organs and oxidative stress after lower limb ischaemia–reperfusion in elderly patients undergoing unilateral knee arthroplasty

Effects of dexmedetomidine on the function of distal organs and oxidative stress after lower limb ischaemia–reperfusion in elderly patients undergoing unilateral knee arthroplasty

Effect of dexmedetomidine on lung function and prognosis a systematic review and meta-analysis

Comparison of bolus administration effects of lidocaine on preventing tourniquet-induced hypertension in patients undergoing general anesthesia: a randomized controlled trial

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