Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation

Kunisawa, Takayuki; Nagata, Osamu; Nagashima, Michio; Mitamura, Sayuri; Ueno, Mariko; Suzuki, Akihiro; Takahata, Osamu; Iwasaki, Hiroshi

doi:10.1016/j.jclinane.2008.08.015

Cited by 73 publications

(64 citation statements)

References 18 publications

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“…Dexmedetomidine was effective for suppressing the rise in heart rate. The results of present study are similar with the studies conducted by Kunisawa et al and Sagiroglu et al 15,16 They stated that dexmedetomidine infusion blunts the hemodynamic changes of intubation and higher doses of dexmedetomidine caused greater reduction in the heart rate.…”

Section: Discussionsupporting

confidence: 92%

Clinical efficacy of dexmedetomidine in two different doses to attenuate the hemodynamic changes during laparoscopic cholecystectomy

Masoori¹,

Gupta²,

Agarwal³

et al. 2018

Int J Res Med Sci

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Background: Laryngoscopy and laparoscopy lead to predictable hemodynamic changes. Dexmedetomidine is selective 2 agonist with dose dependent sedation, sympatholysis and analgesia, hence could provide stable hemodynamics during laparoscopic surgeries. The present study was aimed to compare the clinical efficacy of dexmedetomidine infusion in two different doses to attenuate the hemodynamic variations during laparoscopic cholecystectomy.Methods: Total 60 adult patients of ASA physical status I and II of both gender, scheduled for elective laparoscopic cholecystectomy, were randomly allocated into two groups of 30 patients. All patients were infused with loading dose of dexmedetomidine (1µg/kg) before induction. Patients of Group 1 received maintenance infusion of dexmedetomidine in doses of 0.3µg/kg/h and patients of Group 2 received maintenance infusion of dexmedetomidine in doses of 0.6µg/kg/h, continued till the end of surgery. Heart rate and blood pressure were recorded preoperatively, after dexmedetomidine administration, after induction, intubation, after creation of pneumoperitoneum and postoperatively. Intraoperative changes in heart rate and blood pressure were noted as primary variables and dexmedetomidine related side effects were noted as secondary outcomes, for statistical analysis.Results: The hemodynamic responses were attenuated in patients of both groups after laryngoscopy, intubation and creation of pneumoperitoneum but patients of Group 2 (0.6µg/kg/h) showed more stability in hemodynamics. The difference between the group was statistically significant (p value=0.001). No any evident complication or side effects occurred.Conclusions: Dexmedetomidine infusion was effective for attenuating the hemodynamic changes due to laryngoscopy and laparoscopy but were better with maintenance infusion of dexmedetomidine in dose of 0.6µg/kg/h.

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Section: Discussionsupporting

confidence: 92%

Clinical efficacy of dexmedetomidine in two different doses to attenuate the hemodynamic changes during laparoscopic cholecystectomy

Masoori¹,

Gupta²,

Agarwal³

et al. 2018

Int J Res Med Sci

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“…Hence in our study we administered the bolus dose over 10 minutes. 15 The administration of the test drugs over 10 minutes in our study concurs with the studies conducted by Mowafi et al 10 Basar et al 12 and Kunisawa et al 4 …”

Section: Methods Of Administrationsupporting

confidence: 91%

“…In our study, it was observed that there was a statistically highly significant decrease in the mean HR after the administration of 0.6µg/kg body wt and 1µg/kg body wt of Dexmedetomidine before induction which concurs with the findings of Scheinin et al, 1 Jaakola et al, 2 Basar et al, 12 Keniya et al 13 and Chirag Patel et al 7 Compared to, group DX-0.6, it was observed that there is a statistically highly significant decrease in mean HR in group DX-1 The same thing has also been observed in the studies conducted by Martina Aho et al, 3 Kunisawa et al 4 and Sagiroglu et al 14 who have found that higher doses of Dexmedetomidine produces more decrease in the HR.…”

Section: Changes In Mean Heart Rate In Various Studiessupporting

confidence: 84%

“…The decrease in mean MAP observed at 1 st , 5 th and 10 th minutes after intubation in group DX-0.6 and group DX-1 was statistically highly significant compared to same in group CT(p=0.000). DISCUSSION: Dexmedetomidine has been found by various authors [1][2][3][4][5][10][11][12][13] to blunt the haemodynamic response for laryngoscopy and intubation. Different doses of Dexmedetomidine have been used to find the effectiveness for blunting haemodynamic responses to laryngoscopy and intubation, with conflicting results.…”

Section: Repeated Measure Anovamentioning

confidence: 99%

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A Clinical Study of Effect of Two Different Doses of Dexmed E Tomidine on Haemodynamic Response to Laryngoscopy and Endotracheal Intubation

D¹,

Tegginamath²,

Y³

2015

jemds

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OBJECTIVE OF THE STUDY:To compare the effectiveness of two different doses of Dexmedetomidine, 0.6μg/kg body weight and 1μg/kg body weight in attenuating haemodynamic response to laryngoscopy and endotracheal intubation. MATERIAL AND METHODS: 90 ASA Class 1 patients posted for elective surgery divided into 3 groups, Group DX-0.6 receive Dexmedetomidine, 0.6μg/kg body weight Group DX-1 receive Dexmedetomidine, 1μg/kg body weight and Group CT receive normal saline. The HR, SBP, DBP, MAP recorded at different intervals. OBSERVATIONS: There was a decrease in mean HR in group DX-0.6 and group DX-1 (p=0.000) when compared to group CT at 1 st , 5 th and 10 th minutes after intubation and showed a fall in SBP in group DX-0.6 and group DX-1 at 2 nd min, 5 th min and 8 th min of drug administration and before and after induction compared to group CT. The decrease in mean SBP observed at 1 st , 5 th and 10 th minutes after intubation in group DX-0.6 and group DX-1 was significant compared group CT (p=0.000). Significant fall in DBP in group DX-0.6 and group DX-1 at 8 th min of drug administration and before and after induction compared to group CT. The decrease in mean DBP observed at 1 st , 5 th and 10 th minutes after intubation in group DX-0.6 and group DX-1 was significant compared to group CT (p=0.000). A fall in MAP in group DX-0.6 and group DX-1 at 2 nd min, 5 th min and 8 th min of drug administration and before and after induction compared to group CT. The decrease in mean MAP observed at 1 st , 5 th and 10 th minutes after intubation in group DX-0.6 and group DX-1 was significant compared to group CT(p=0.000). CONCLUSION: Dexmedetomidine -0.6µg/kg body weight and 1µg/kg body weight are equally efficacious in obtunding the haemodynamic responses to laryngoscopy and endotracheal intubation. KEYWORDS: Different doses of dexmeditomedine, laryngoscopy, intubation. BACKGROUND:Dexmedetomidine in the dose of 0.6µg/kg body weight 1-3 and 1µg/kg body weight 4-7 as intravenous bolus for attenuating the haemodynamic response. There are conflicting reports as to which dose of the drug is idealy to suppress the intubation response and also have minimal adverse effects. So, the present study is aimed at comparing the effectiveness of two different doses of intravenous Dexmedetomidine, 0.6µg/kg body weight and 1µg/kg body weight for attenuating haemodynamic response to laryngoscopy and endotracheal intubation.

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“…This is likely due to the fact that midazolam decreases systemic vascular resistance (Jones et al 1979;Samuelson et al 1981) which is often accompanied by compensatory decreases in PR. Kunisawa et al (2009) reported that administration of dexmedetomidine in combination with other anaesthetics during anaesthetic induction may prevent a decrease in blood pressure. The results of our study suggest that the effects of dexmedetomidine probably temporarily and partially counterbalance the hypotension effect of midazolam at 5, 10, and 20 min after anaesthesia.…”

Section: Murthy and Singh 2009)mentioning

confidence: 99%

Effects of the dexmedetomidine, midazolam, butorphanol, and atropine combination on plasma oxidative status and cardiorespiratory parameters in raccoon dogs (Nyctereutes procyonoides)

Feng¹,

Hu²,

Zhang³

et al. 2015

Vet. Med. - Czech

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ABSTRACT:Oxidative stress in the body occurs when the production of free radicals overwhelms the antioxidant defence systems. This study aimed to investigate the effects of a combination of dexmedetomidine, midazolam, butorphanol, and atropine (DMBA) as an anaesthetic on plasma oxidative status in twelve raccoon dogs. Baseline measures were recorded prior to anaesthesia, and then the animals were anaesthetised with the combination of dexmedetomidine (25 µg/kg), midazolam (0.45 mg/kg), butorphanol (0.25 mg/kg), and atropine (0.035 mg/kg). Temperature, respiratory rate, haemoglobin saturation by oxygen, pulse rate, systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure were continually monitored. Blood pressure was significantly decreased at 30 to 60 min (P < 0.05). Pulse rate ranged from 96 to 123 bpm, without episodes of severe bradycardia or tachycardia. Blood samples were collected from saphenous venipuncture at 0, 0.5, 1, and 24 h before, during, and after anaesthesia. Plasma superoxide dismutase, glutathione peroxidase, and catalase activity, and malondialdehyde concentrations were measured by colorimetry, and plasma vitamin E level was determined by high-performance liquid chromatography. Superoxide dismutase and glutathione peroxidase activities increased significantly (P < 0.05) at 0.5 h, and then gradually decreased to baseline values after 1 h. Catalase activity increased significantly (P < 0.05) at 0.5 h, 1 h, and then gradually decreased to baseline values after 24 h. There was no significant change in vitamin E level (P < 0.05).The concentration of malondialdehyde decreased significantly at 0.5, 1, and 24 h after injection (P < 0.05). The results show that the administered dose of dexmedetomidine, midazolam, butorphanol, and atropine has antioxidant effects in raccoon dogs. Our study is the first to demonstrate that dexmedetomidine, midazolam, butorphanol, and atropine exert antioxidant effects, which may be exploited to alleviate the stress of examination and research at veterinary clinics.

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Dexmedetomidine suppresses the decrease in blood pressure during anesthetic induction and blunts the cardiovascular response to tracheal intubation

Cited by 73 publications

References 18 publications

Clinical efficacy of dexmedetomidine in two different doses to attenuate the hemodynamic changes during laparoscopic cholecystectomy

Clinical efficacy of dexmedetomidine in two different doses to attenuate the hemodynamic changes during laparoscopic cholecystectomy

A Clinical Study of Effect of Two Different Doses of Dexmed E Tomidine on Haemodynamic Response to Laryngoscopy and Endotracheal Intubation

Effects of the dexmedetomidine, midazolam, butorphanol, and atropine combination on plasma oxidative status and cardiorespiratory parameters in raccoon dogs (Nyctereutes procyonoides)

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