A comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass grafting
Context: Direct laryngoscopy and endotracheal intubation are the most stressful periods during induction of anesthesia. These events can lead to hypertension, tachycardia, arrhythmias and myocardial ischaemia. Aims: (1) To evaluate the haemodynamic response to laryngoscopy and endotracheal intubatio...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wolters Kluwer Medknow Publications
2014-01-01
|
Series: | Journal of the Scientific Society |
Subjects: | |
Online Access: | http://www.jscisociety.com/article.asp?issn=0974-5009;year=2014;volume=41;issue=3;spage=151;epage=155;aulast=Sulhyan |
_version_ | 1818623583943917568 |
---|---|
author | Soniya R Sulhyan Anand T Vagarali Sharangouda S Patil Mahadev D Dixit |
author_facet | Soniya R Sulhyan Anand T Vagarali Sharangouda S Patil Mahadev D Dixit |
author_sort | Soniya R Sulhyan |
collection | DOAJ |
description | Context: Direct laryngoscopy and endotracheal intubation are the most stressful periods during induction of anesthesia. These events can lead to hypertension, tachycardia, arrhythmias and myocardial ischaemia. Aims: (1) To evaluate the haemodynamic response to laryngoscopy and endotracheal intubation with a single preinduction infusion of dexmedetomidine (DEX) 1 μg/kg over a 10 min period, (2) To assess the incidence of side effects, that is, rebound hypertension, bradycardia and hypotension etc., associated with the use of DEX. Settings and Design: This was a prospective, double-blind, parallel group randomized clinical trial of DEX (1 μg/kg) before anesthetic induction to study the attenuation of hemodynamic response to endotracheal intubation in 60 adult patients undergoing elective off pump coronary arterial bypass grafting. Materials and Methods: Patients were randomly allocated to receive either DEX (DEX group, n = 30) or 0.9% normal saline (PLA group, n = 30). Hemodynamic variables were recorded at baseline (Abbreviated as TB), after completion of drug infusion (Abbreviated as TC), 3 min after induction and immediately before intubation (T0), at the 1 st (T1), 3 rd (T3) and 5 th (T5) min after intubation. Statistical Analysis Used: The data are presented as mean ± standard deviation. Demographic data were analysed by Student′s t-test between the two groups. Analysis of variance for repeated measures f-test was used to analyze changes over time. A P < 0.05 was considered as significant and P < 0.01 or 0.001 was considered as highly significant. Results: All the hemodynamic variables were comparable in both groups at baseline. Heart rate values were statistically significantly lower in the DEX group at TC and highly statistically significantly lower at T1, T3 and T5 values. Systolic blood pressure values were statistically significantly lower in the DEX group at T0 and highly statistically significantly lower at T1, T3 and T5. Diastolic blood pressure and mean blood pressure values and systolic pulmonary artery pressure values were highly statistically significantly lower in the DEX group at T1, T3 and T5. Diastolic pulmonary artery pressure were statistically significantly lower in the DEX group at TC, T0 and T1 and highly statistically significantly lower at T3. Mean pulmonary artery pressure were statistically significantly lower in the DEX group at T0 and highly statistically significantly lower at TC, T1 and T3. Arterial oxygen saturation was statistically significantly lower in the DEX group at TC. There was no case of hypotension or bradycardia in our case series. Conclusions: Dexmedetomeditine (1 μg/kg) attenuates hemodynamic response to laryngoscopy and intubation in elective surgery for off pump coronary artery bypass grafting. |
first_indexed | 2024-12-16T18:43:23Z |
format | Article |
id | doaj.art-0b186eb007c9428aabd40c38ae300c82 |
institution | Directory Open Access Journal |
issn | 0974-5009 |
language | English |
last_indexed | 2024-12-16T18:43:23Z |
publishDate | 2014-01-01 |
publisher | Wolters Kluwer Medknow Publications |
record_format | Article |
series | Journal of the Scientific Society |
spelling | doaj.art-0b186eb007c9428aabd40c38ae300c822022-12-21T22:20:56ZengWolters Kluwer Medknow PublicationsJournal of the Scientific Society0974-50092014-01-0141315115510.4103/0974-5009.141198A comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass graftingSoniya R SulhyanAnand T VagaraliSharangouda S PatilMahadev D DixitContext: Direct laryngoscopy and endotracheal intubation are the most stressful periods during induction of anesthesia. These events can lead to hypertension, tachycardia, arrhythmias and myocardial ischaemia. Aims: (1) To evaluate the haemodynamic response to laryngoscopy and endotracheal intubation with a single preinduction infusion of dexmedetomidine (DEX) 1 μg/kg over a 10 min period, (2) To assess the incidence of side effects, that is, rebound hypertension, bradycardia and hypotension etc., associated with the use of DEX. Settings and Design: This was a prospective, double-blind, parallel group randomized clinical trial of DEX (1 μg/kg) before anesthetic induction to study the attenuation of hemodynamic response to endotracheal intubation in 60 adult patients undergoing elective off pump coronary arterial bypass grafting. Materials and Methods: Patients were randomly allocated to receive either DEX (DEX group, n = 30) or 0.9% normal saline (PLA group, n = 30). Hemodynamic variables were recorded at baseline (Abbreviated as TB), after completion of drug infusion (Abbreviated as TC), 3 min after induction and immediately before intubation (T0), at the 1 st (T1), 3 rd (T3) and 5 th (T5) min after intubation. Statistical Analysis Used: The data are presented as mean ± standard deviation. Demographic data were analysed by Student′s t-test between the two groups. Analysis of variance for repeated measures f-test was used to analyze changes over time. A P < 0.05 was considered as significant and P < 0.01 or 0.001 was considered as highly significant. Results: All the hemodynamic variables were comparable in both groups at baseline. Heart rate values were statistically significantly lower in the DEX group at TC and highly statistically significantly lower at T1, T3 and T5 values. Systolic blood pressure values were statistically significantly lower in the DEX group at T0 and highly statistically significantly lower at T1, T3 and T5. Diastolic blood pressure and mean blood pressure values and systolic pulmonary artery pressure values were highly statistically significantly lower in the DEX group at T1, T3 and T5. Diastolic pulmonary artery pressure were statistically significantly lower in the DEX group at TC, T0 and T1 and highly statistically significantly lower at T3. Mean pulmonary artery pressure were statistically significantly lower in the DEX group at T0 and highly statistically significantly lower at TC, T1 and T3. Arterial oxygen saturation was statistically significantly lower in the DEX group at TC. There was no case of hypotension or bradycardia in our case series. Conclusions: Dexmedetomeditine (1 μg/kg) attenuates hemodynamic response to laryngoscopy and intubation in elective surgery for off pump coronary artery bypass grafting.http://www.jscisociety.com/article.asp?issn=0974-5009;year=2014;volume=41;issue=3;spage=151;epage=155;aulast=SulhyanDexmedetomidineintubationoff pump coronary artery bypass grafting |
spellingShingle | Soniya R Sulhyan Anand T Vagarali Sharangouda S Patil Mahadev D Dixit A comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass grafting Journal of the Scientific Society Dexmedetomidine intubation off pump coronary artery bypass grafting |
title | A comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass grafting |
title_full | A comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass grafting |
title_fullStr | A comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass grafting |
title_full_unstemmed | A comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass grafting |
title_short | A comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass grafting |
title_sort | comparative clinical study of dexmedetomidine versus placebo to attenuate hemodynamic response to endotracheal intubation in patients undergoing off pump coronary arterial bypass grafting |
topic | Dexmedetomidine intubation off pump coronary artery bypass grafting |
url | http://www.jscisociety.com/article.asp?issn=0974-5009;year=2014;volume=41;issue=3;spage=151;epage=155;aulast=Sulhyan |
work_keys_str_mv | AT soniyarsulhyan acomparativeclinicalstudyofdexmedetomidineversusplacebotoattenuatehemodynamicresponsetoendotrachealintubationinpatientsundergoingoffpumpcoronaryarterialbypassgrafting AT anandtvagarali acomparativeclinicalstudyofdexmedetomidineversusplacebotoattenuatehemodynamicresponsetoendotrachealintubationinpatientsundergoingoffpumpcoronaryarterialbypassgrafting AT sharangoudaspatil acomparativeclinicalstudyofdexmedetomidineversusplacebotoattenuatehemodynamicresponsetoendotrachealintubationinpatientsundergoingoffpumpcoronaryarterialbypassgrafting AT mahadevddixit acomparativeclinicalstudyofdexmedetomidineversusplacebotoattenuatehemodynamicresponsetoendotrachealintubationinpatientsundergoingoffpumpcoronaryarterialbypassgrafting AT soniyarsulhyan comparativeclinicalstudyofdexmedetomidineversusplacebotoattenuatehemodynamicresponsetoendotrachealintubationinpatientsundergoingoffpumpcoronaryarterialbypassgrafting AT anandtvagarali comparativeclinicalstudyofdexmedetomidineversusplacebotoattenuatehemodynamicresponsetoendotrachealintubationinpatientsundergoingoffpumpcoronaryarterialbypassgrafting AT sharangoudaspatil comparativeclinicalstudyofdexmedetomidineversusplacebotoattenuatehemodynamicresponsetoendotrachealintubationinpatientsundergoingoffpumpcoronaryarterialbypassgrafting AT mahadevddixit comparativeclinicalstudyofdexmedetomidineversusplacebotoattenuatehemodynamicresponsetoendotrachealintubationinpatientsundergoingoffpumpcoronaryarterialbypassgrafting |