A small dose of dexmedetomidine decreased the postoperative bleeding by reducing cough and emergence agitation after thyroidectomy – A randomized, double-blind, controlled study

Abstract

Background: Bleeding after a thyroidectomy occurs due to violent cough during the emergence. Dexmedetomidine is helpful for smooth emergence and suppressing the cough. The purpose of the present study was to compare the effect of dexmedetomidine on postoperative bleeding after thyroidectomy. Methods: Randomized, double-blind, controlled trial in female patients (ASA I–II, aged 20 to 60 years) were conducted. Patients were randomly allocated into two groups. About fifteen minutes before the end of the surgery, dexmedetomidine was administered (0.6 μg/kg/hr) without a loading dose in group D (n=69), and normal saline was administered in group S (n=70) at the same infusion rate. Hemodynamic data, coughing reflex, extubation time, Ramsay sedation scale (RSS), recovery time were assessed during the administration of study drugs and recovery from anesthesia. Amounts of postoperative hemorrhage were measured for 3 days. Results: A total of 139 patients were analyzed. The incidence of severe cough was significantly decreased in group D compared to group S (4.3% vs. 11.5%, P = 0.022). Emergence agitation in the postanesthetic care unit was significantly decreased in group D compared to group S (P = 0.01). Postoperative bleeding showed a significant decrease in group D compared to group S until the second postoperative day (P = 0.015). Conclusions: Dexmedetomidine can decrease postoperative bleeding by reducing coughing and emergence agitation after thyroidectomy. Trial registration: This study was registered at http://clinicaltrials.gov (registration number NCT02412150, 09/04/2015).