Comparison of effect of dexmedetomidine and lidocaine on intracranial and systemic hemodynamic response to chest physiotherapy and tracheal suctioning in patients with severe traumatic brain injury

Singh, Shalendra; Chouhan, Rajendra Singh; Bindra, Ashish; Radhakrishna, Nayani

doi:10.1007/s00540-018-2505-9

Cited by 26 publications

(25 citation statements)

References 25 publications

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“…The variations in the stimulation of the airway caused by the differences in suction methods, suction duration, negative pressure applied, and suction tube insertion depth, are re ected in ICP changes [4-11, 16, 17]. It has been previously demonstrated that ES is an important factor affecting ICP [12][13][14][15][16]. The results of the current work showed that the average peak value of ICP in the experimental group was 15.57 ± 12.31 mmHg, while that in the control group was 18.24 ± 8.99 mmHg.…”

Section: Discussionmentioning

confidence: 99%

“…ES stimulates airway mucosa, triggers cough re ex, induces bronchospasm, decreases blood oxygen saturation, and increases intracranial pressure. Severe airway stimulation may lead to adverse consequences [1], such as severe cough, increased chest pressure, a sudden rise in blood pressure, increased cerebral perfusion, increased intracranial pressure (ICP) caused by cerebral vasospasm, and increased risk of vascular rupture [12][13][14][15][16]. The stimulation of the airway caused by different suction modes and duration, the amount of negative pressure applied, and the depth of suction tube insertion lead to re exive ICP changes [4-11, 16, 17].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Propofol on Intracranial Pressure and Prognosis in Severe Neuropathy Patients Undergoing Endotracheal Suctioning

Wu¹,

Xi²,

Chen³

et al. 2020

Preprint

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Background To investigate whether intravenous propofol before endotracheal suctioning (ES) in severe neuropathy patients can reduce the sputum suction response, improve the prognosis, and accelerate recovery.Methods A total of 208 severe neuropathy patients after craniocerebral surgery were enrolled in the study. The subjects were randomly divided into the experimental group (n=104) and the control group (n=104). The experimental group was given intravenous propofol, 0.5-1 mg/kg, before ES, while the control group was subjected to ES only. Changes in vital signs, sputum suction effect, the fluctuation range of intracranial pressure (ICP) before and after ES, choking cough response, short-term complications, and length of stay and hospitalization cost were evaluated. Additionally, the Glasgow Outcome Scale (GOS) prognosis score was obtained at six months after the operation.Results At the baseline, the characteristics of the two groups were comparable (P>0.05). The increase of systolic blood pressure after ES was higher in the control group than in the experimental group (P < 0.05). The average peak value of ICP in the experimental group during the suctioning (15.57 ± 12.31 mmHg) was lower than in the control group (18.24 ± 8.99 mmHg; P < 0.05). The percentage of patients experiencing cough reaction and pain during suctioning in the experimental group was lower than in the control group (P < 0.05), and the fluctuation range of ICP was increased (P < 0.0001). The effect of ES was achieved in both groups. The incidence of short-term complications in the two groups was comparable (P > 0.05). The difference at 6 months after the surgery, the GOS scores were significantly higher in the experimental than in the control group (4-5 points, 51.54% vs. 32.64%; 1-3 points, 48.46% vs. 67.36%; P<0.05). There was no significant difference in the length of stay and hospitalization cost between the two groups.Conclusions Propofol sedation before ES can reduce the choking cough response, the pain experience of patients, and the intracranial hypertension response. The use of propofol is safe and improves long-term prognosis.The study was registered in the Chinese Clinical Trial Registry on May 16, 2015 (ChiCTR-IOR-15006441).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Propofol on Intracranial Pressure and Prognosis in Severe Neuropathy Patients Undergoing Endotracheal Suctioning

Wu¹,

Xi²,

Chen³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The variations in the stimulation of the airway caused by the differences in suction methods, suction duration, negative pressure applied, and suction tube insertion depth, are re ected in ICP changes [4][5][6][9][10][11][12]. Previous studies had demonstrated that ES was an important factor affecting ICP [6][7][8]. The results of the current work showed that the average peak value of ICP in the experimental group was 15.57 ± 12.31 mmHg, while that in the control group was 18.24 ± 8.99 mmHg.…”

Section: Propofol Sedation Before Es Helps To Stabilize Intracranial mentioning

confidence: 99%

“…The sputum suction tube repeatedly stimulates the respiratory mucosa, resulting in varying degrees of choking and coughing in patients. In severe cases, it causes a decrease in blood oxygen saturation and an increase in ICP, producing discomfort [4][5][6][7][8]. Propofol is a short-term anesthesia drug, which is rapidly distributed in the entire organism within 40 seconds after intravenous injection.…”

Section: Propofol Sedation Ensures Es Effectmentioning

confidence: 99%

“…To maintain airway patency and avoid airway obstruction and pulmonary infection in patients affected by the severe brain disease, arti cial airways should be established, and endotracheal suctioning (ES) should be timely repeatedly performed [1,4,5].</p> <p>ES stimulates airway mucosa, triggers cough re ex, induces bronchospasm, decreases blood oxygen saturation, and increases intracranial pressure. However, severe airway stimulation may lead to adverse consequences [1], such as severe cough, increased chest pressure, a sudden rise in blood pressure, increased cerebral perfusion, increased intracranial pressure (ICP) caused by cerebral vasospasm, and increased risk of vascular rupture [6][7][8]. The stimulation of the airway caused by different suction modes and duration, the amount of negative pressure applied, and the depth of suction tube insertion lead to re exive ICP changes [4-6,9-12.</p> <p>Propofol, a short-term acting sedative, can reduce the cerebral blood ow, ICP, and cerebral metabolic rate of oxygen (CMRO2).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Propofol on Intracranial Pressure and Prognosis in Patients with Severe Brain Diseases Undergoing Endotracheal Suctioning

Wu¹,

Xi²,

Chen³

et al. 2020

Preprint

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Background To investigate whether the administration of intravenous propofol before endotracheal suctioning (ES) in patients with severe brain disease can reduce the sputum suction response, improve prognosis, and accelerate recovery.Methods A total of 208 severe brain disease patients after craniocerebral surgery were enrolled in the study. The subjects were randomly assigned to the experimental group (n=104) and the control group (n=104). The experimental group was given intravenous propofol (10ml propofol with 1ml 2% lidocaine), 0.5-1 mg/kg, before ES, while the control group was subjected to ES only. Changes in vital signs, sputum suction effect, the fluctuation range of intracranial pressure (ICP) before and after ES, choking cough response, short-term complications, length of stay, and hospitalization cost were evaluated. Additionally, the Glasgow Outcome Scale (GOS) prognosis score was obtained at six months after the operation.Results At the baseline, the characteristics of the two groups were comparable (P>0.05). The increase of systolic blood pressure after ES was higher in the control group than in the experimental group (P < 0.05). The average peak value of ICP in the experimental group during the suctioning (15.57 ± 12.31 mmHg) was lower than in the control group (18.24 ± 8.99 mmHg; P < 0.05). The percentage of patients experiencing cough reaction- during suctioning in the experimental group was lower than in the control group (P < 0.05), and the fluctuation range of ICP was increased (P < 0.0001). The effect of ES was achieved in both groups. The incidence of short-term complications in the two groups was comparable (P > 0.05). At 6 months after the surgery, the GOS scores were significantly higher in the experimental than in the control group (4-5 points, 51.54% vs. 32.64%; 1-3 points, 48.46% vs. 67.36%; P<0.05). There was no significant difference in the length of stay and hospitalization cost between the two groups.Conclusions Propofol sedation before ES could reduce choking cough response and intracranial hypertension response. The use of propofol was safe and improved the long-term prognosis.The study was registered in the Chinese Clinical Trial Registry on May 16, 2015 (ChiCTR-IOR-15006441).

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Management of severe traumatic brain injury in pediatric patients: an evidence-based approach

de Carvalho Panzeri Carlotti,

do Amaral,

de Carvalho Canela Balzi

et al. 2024

Neurol Sci

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Comparison of effect of dexmedetomidine and lidocaine on intracranial and systemic hemodynamic response to chest physiotherapy and tracheal suctioning in patients with severe traumatic brain injury

Abstract: Both dexmedetomidine and lidocaine were effective to blunt rise in HR, MAP and ICP in response to CP and TS in patients with sTBI. However, intravenous dexmedetomidine caused significant decrease in MAP and CPP as compared to the baseline and lidocaine.

Cited by 26 publications

References 25 publications

Effects of Propofol on Intracranial Pressure and Prognosis in Severe Neuropathy Patients Undergoing Endotracheal Suctioning

Effects of Propofol on Intracranial Pressure and Prognosis in Severe Neuropathy Patients Undergoing Endotracheal Suctioning

Effects of Propofol on Intracranial Pressure and Prognosis in Patients with Severe Brain Diseases Undergoing Endotracheal Suctioning

Management of severe traumatic brain injury in pediatric patients: an evidence-based approach

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