The effect of dexmedetomidine on decrease of cough, hemodynamic parameters and Ramsay score versus lidocaine during general anesthesia: a randomized clinical trial

Abstract

Physiological responses remain common during anesthesia emergence and endotracheal extubation, causing some complications. We aimed to address the effect of dexmedetomidine (DEX) on decrease of cough, hemodynamic parameters and Ramsay score in comparing to lidocaine (LID) during anesthesia. In this double-blinded randomized clinical trial 120 hospitalized patients undergoing general anesthesia were enrolled after obtaining written consent. Block random allocation was used to assign patients into three groups including DEX (intravenous injection; 0.5 μg/kg), LID (1.5 mg/kg), and PBO (10 mL normal saline) at 10 minutes before anesthesia. No statistical significance was uncovered among three groups in blood pressure, oxygen saturation, frequency of laryngospasm and duration of surgery amongst the groups ( P > 0.05), but DEX having lower heart rate and cough frequency ( P < 0.05). Moreover, the mean of Ramsay score was statistically higher in DEX and LID groups than PBO except at the 50 th and 60 th minutes after extubation ( P < 0.05). Since the mean of Ramsay score was higher in DEX vs . LID groups and reduced heart rate and cough frequency demonstrates in DEX, it seems that DEX could be an appropriate drug on suppressing cough during anesthesia without side effects. The study protocol was approved by the Ethical Committee of Arak University of Medical Sciences by code IR.ARAKMU.REC.1397.140 on August 19, 2018, and the protocol was registered at Iranian Registry of Clinical Trials by code IRCT20141209020258N97 on February 22, 2019.

Determining the Optimal Dosage of Dexmedetomidine for Smooth Emergence in Older Patients Undergoing Spinal Surgery: A Study of 44 Cases

“…Dexmedetomidine is a selective α2-receptor agonist with sympatholytic, sedative, anxiolytic, and analgesic properties [ 19 ]. Furthermore, it is among the most effective agents for alleviating cough during anesthesia emergence to obtain a smooth emergence [ 20 ]. However, owing to variations in target groups and regimens in small-series studies, the administration method and appropriate dosage have not been clearly determined, especially in older patients.…”

Efficacy appraisal of four regimens (granisetron, ketamine, dexmedetomidine, and lidocaine combined with fentanyl) for cystoscopy-associated sedation and analgesia and catheter-related bladder tolerance: a randomized clinical trial

“…It contributes to maintaining hemodynamic stability, produces anesthetic and analgesic effects, reduces the need for opioids, their complications, and stress response, and improves the quality of recovery. [ 15 28 ] DEX analgesic effects can be through activation of the α2 adrenergic receptor in the dorsal horn of the spinal cord and the inhibitory influence on substance P-release. [ 12 ]…”

Effect of dexmedetomidine on convalescence quality after general anesthesia and postoperative delirium, and on cognitive function in elderly patients undergoing lower limb surgery

“…Ramsay sedation score [11] and Visual Analogue Scale (VAS) [12] were used to evaluate sedation and analgesia effects at 4, 12 and 24 h after recovery, respectively. Ramsay score ranged from 1 (restlessness) to 6 (deep sleep), and higher score, indicates better sedative effect.…”