Rashmi H D, Komala H K
Department of Anesthesiology, Adichunchanagiri Institute of Medical Sciences, Mandya, Bellur, Karnataka, India.
Anesth Essays Res. 2016 Sep-Dec;10(3):483-487. doi: 10.4103/0259-1162.179311.
The procedures in anesthesia such as laryngoscopy and endotracheal intubation are the most important skills to be mastered by an anesthesiologist. However, they produce marked cardiovascular responses such as hypertension and tachycardia. Various drugs have been used to suppress this response. One of those is a novel centrally acting α agonist - dexmedetomidine. It has numerous uses in anesthesia as it is having sedative, analgesic, hypnotic, and opioid sparing effects. It is also known to suppress the hemodynamic response to laryngoscopy and intubation.
This study is aimed to know the effect of intravenous dexmedetomidine 0.6 μg/kg body weight on hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing thyroid surgeries.
Sixty patients of American Society of Anaesthesiologist health status class I and II scheduled for thyroid surgery under general anesthesia were considered in this prospective randomized controlled double-blind study. The study population was randomly divided into two groups with 30 patients in each group using sealed envelopes containing the name of the group and patient is asked to pick up the envelope.
Sixty euthyroid patients, scheduled for thyroid surgeries was randomly divided into two groups with 30 patients in each group. Group A ( = 30) received injection dexmedetomidine 0.6 μg/kg body weight and Group B ( = 30) received 10 ml of normal saline. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at regular intervals after intubation.
Statistically significant decrease in HR, SBP, DBP, and MAP were observed in Group A after intubation when compared to Group B.
We conclude that dexmedetomidine 0.6 μg/kg body weight obtunds the hemodynamic responses to laryngoscopy and tracheal intubation in patients undergoing thyroid surgeries.
麻醉操作如喉镜检查和气管插管是麻醉医生必须掌握的最重要技能。然而，这些操作会引发显著的心血管反应，如高血压和心动过速。已使用多种药物来抑制这种反应。其中之一是一种新型中枢作用α激动剂——右美托咪定。它在麻醉中有多种用途，具有镇静、镇痛、催眠和节省阿片类药物的作用。它还已知可抑制喉镜检查和插管时的血流动力学反应。
本研究旨在了解静脉注射0.6μg/千克体重的右美托咪定对甲状腺手术患者喉镜检查和气管插管血流动力学反应的影响。
本前瞻性随机对照双盲研究纳入了60例美国麻醉医师协会健康状况分级为I级和II级、计划在全身麻醉下进行甲状腺手术的患者。使用装有分组名称的密封信封将研究人群随机分为两组，每组30例患者，并让患者抽取信封。
60例计划进行甲状腺手术的甲状腺功能正常患者随机分为两组，每组30例。A组（n = 30）接受0.6μg/千克体重的右美托咪定注射，B组（n = 30）接受10ml生理盐水。插管后定期记录心率（HR）、收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP）。
与B组相比，A组插管后HR、SBP、DBP和MAP在统计学上有显著下降。
我们得出结论，0.6μg/千克体重的右美托咪定可减轻甲状腺手术患者喉镜检查和气管插管时的血流动力学反应。
