Indira Gandhi Institute of Medical Sciences, Department of Anesthesiology and Critical Care Medicine, Patna, India.
Indira Gandhi Institute of Medical Sciences, Department of Anesthesiology and Critical Care Medicine, Patna, India.
Braz J Anesthesiol. 2022 Jan-Feb;72(1):103-109. doi: 10.1016/j.bjane.2021.02.060. Epub 2021 May 14.
Laryngoscopy and tracheal intubation lead to a sympathoadrenal response. We compared the efficacy of dexmedetomidine with fentanyl bolus to attenuate this response.
One hundred patients admitted for routine surgical procedures under general anesthesia were enrolled in this double blind, randomized, controlled study. Patients were randomly assigned to two groups: Group F received injection of fentanyl 2 μg.kg and Group D received injection of dexmedetomidine 0.5 μg.kg diluted up to 5 mL by adding normal saline intravenously over 60 seconds. Five minutes thereafter, following induction with propofol and vecuronium, tracheal intubation was performed after 3 minutes of mask ventilation. Hemodynamic parameters were observed at an interval of 2 minutes before tracheal intubation and at an interval of 1 minute for 5 minutes after tracheal tube cuff inflation. Continuous variables are presented as mean with 95% confidence interval, and t-test was applied for comparing the difference of means between two groups after checking the normality condition. Chi-square test was applied to test the independence of attributes of categorical variables. Repeated measures two-way ANOVA was performed to compare the outcome variables between the two groups.
The difference in heart rate and mean arterial pressure of patients in two groups after laryngoscopy and intubation was not statistically significant at any point of time. The hemodynamic changes did not require any intervention in the form of administration of rescue medication.
Dexmedetomidine 0.5 μg.kg is as effective as fentanyl 2 μg.kg in attenuating the hemodynamic response accompanying laryngoscopy and tracheal intubation.
CLINICAL TRIAL NUMBER & REGISTRY URL: CTRI/2017/09/009857 [ctri.nic.in].
喉镜检查和气管插管会引起交感肾上腺反应。我们比较了右美托咪定与芬太尼推注以减轻这种反应的效果。
本双盲、随机、对照研究纳入了 100 例接受全身麻醉下常规手术的患者。患者被随机分配到两组：组 F 接受芬太尼 2μg/kg 注射，组 D 接受右美托咪定 0.5μg/kg 静脉注射，用生理盐水稀释至 5mL，60 秒内注入。5 分钟后，在异丙酚和维库溴铵诱导后，面罩通气 3 分钟后进行气管插管。在气管插管前每隔 2 分钟和气管导管套囊充气后每隔 1 分钟观察血流动力学参数。连续变量以均数及 95%置信区间表示，在检查正态性条件后，应用 t 检验比较两组之间均数的差异。卡方检验用于检验分类变量属性的独立性。重复测量双向方差分析用于比较两组之间的结果变量。
两组患者在喉镜检查和插管后任何时间点的心率和平均动脉压差异均无统计学意义。血流动力学变化无需以给予抢救药物的形式进行任何干预。
右美托咪定 0.5μg/kg 与芬太尼 2μg/kg 一样有效，可减轻喉镜检查和气管插管伴随的血流动力学反应。
CTRI/2017/09/009857 [ctri.nic.in]。
