Efficacy of intraoperative dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery

Kim, S. Y.; Kim, J. M.; Lee, Jae H.; Song, Bijia; Koo, Bon‐Nyeo

doi:10.1093/bja/aet056

Cited by 145 publications

(146 citation statements)

References 22 publications

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“…23 Nevertheless, a single dose of dexmedetomidine did not prolong the PACU LOS in accordance with a previous study of intraoperative dexmedetomidine infusion. 12 The incidence of coughing in our study was relatively high (64% in Group D and 91% in Group P, respectively) compared with previous studies (up to 74%, even in a placebo control group) in patients after thyroidectomy under sevoflurane and remifentanil. 4,24,25 The difference might be due to the characteristics of the patients in our study, the intensity of tactile stimuli during emergence from anesthesia, and the investigator's technique during extubation.…”

Section: Discussioncontrasting

confidence: 65%

“…21 A recent study in adults after nasal surgery showed that an intraoperative dexmedetomidine infusion allowed for a smooth emergence from anesthesia by suppressing agitation. 12 In that study, an intraoperative infusion of dexmedetomidine alone did not reduce the severity of cough and the median value of cough grade during emergence was still high. In our study, additional dexmedetomidine not only reduced the incidence of any coughing but also reduced the severity of coughing in the presence of tracheal intubation and at extubation.…”

Section: Discussionmentioning

confidence: 76%

“…11 In addition, dexmedetomidine has been shown to reduce emergence agitation in children and adults after general anesthesia. 12,13 Nevertheless, there has been limited investigation regarding the efficacy of a single dose of dexmedetomidine in preventing cough during emergence from anesthesia.…”

mentioning

confidence: 99%

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Efficacy of a single dose of dexmedetomidine for cough suppression during anesthetic emergence: a randomized controlled trial

Lee

Choi

Kang

et al. 2014

Can J Anesth/J Can Anesth

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Purpose Maintenance of a remifentanil infusion during anesthetic emergence has been reported to decrease the incidence of coughing and thereby help to ensure a smooth emergence. It may, however, cause respiratory depression and possibly delay emergence. The purpose of this study was to investigate the effect of a single dose of dexmedetomidine combined with a low-dose remifentanil infusion on cough suppression during emergence from general anesthesia. Methods American Society of Anesthesiologists physical status I-II adults undergoing elective thyroidectomy under sevoflurane anesthesia were recruited and randomly allocated to receive either dexmedetomidine 0.5 lgÁkg -1 iv (Group D, n = 70) or saline (Group S, n = 71), each combined with a low-dose remifentanil infusion ten minutes before the end of surgery. Coughing was assessed using a four-point scale. The respiratory rate (RR), heart rate (HR), and mean arterial pressure were also recorded. Results The incidence of coughing was lower in Group D than in Group S (64% vs 91%, respectively; mean difference 27%; 95% confidence interval [CI] 13 to 41; P \ 0.001). The median cough grade at extubation was also lower in Group D. Mean arterial pressure and HR were elevated in Group S during tracheal extubation but were similar to baseline values in Group D. There was no difference in RR between the two groups throughout the study. A small delay in extubation was observed in Group D (3 minutes longer than Group S; 95% CI 2 to 4; P \ 0.001). Conclusion Compared with an infusion of low-dose remifentanil alone, the addition of a single dose (0.5 lgÁkg -1 ) of dexmedetomidine during emergence from sevofluraneremifentanil anesthesia was effective in attenuating coughing and hemodynamic changes and did not exacerbate respiratory depression after thyroid surgery. This trial was registered at Clinicaltrial.gov, identifier: NCT01774305. RésuméObjectif Il a été rapporté que le maintien d'une perfusion de remifentanil pendant l'émergence anesthésique diminuait This study was presented as a scientific poster at the

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 76%

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Efficacy of a single dose of dexmedetomidine for cough suppression during anesthetic emergence: a randomized controlled trial

Lee

Choi

Kang

et al. 2014

Can J Anesth/J Can Anesth

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“…In our study we used the Ricker sedation-agitation scale 10 . The incidence of emergence agitation in the control group in our study is 50%, which is similar to the results of previous studies 1,15 .…”

Section: Discussionsupporting

confidence: 92%

Effect of Dexmedetomidine on Emergence Agitation after Nasal Surgeries

Khurshid¹,

Muneer²,

Malla³

2015

jmscr

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“…The uses of dexmedetomidine have been extended to include general anaesthesia, where it is used as an adjuvant drug for pre-medication and co-induction in total intravenous anaesthesia (TIVA). Studies showed that dexmedetomidine was associated with better perioperative haemodynamic control, less intra-operative opioid consumption, fewer requests for postoperative antiemetics, reduced total propofol dose requirements and smooth emergence (3)(4)(5).…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Effects of Dexmedetomidine on the Induction of Anaesthesia Using Marsh and Schnider Pharmacokinetic Models of Propofol Target-Controlled Infusion

Hassan

2018

MJMS

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Background: The study aimed to determine the effects of dexmedetomidine on the induction of anaesthesia using different models (Marsh and Schnider) of propofol targetcontrolled infusion (TCI).Methods: Sixty-four patients aged 18-60 years, American Society of Anaesthesiologists (ASA) class I-II who underwent elective surgery were randomised to a Marsh group (n = 32) or Schnider group (n = 32). All the patients received a 1 µg/kg loading dose of dexmedetomidine, followed by TCI anaesthesia with remifentanil at 2 ng/mL. After the effect-site concentration (Ce) of remifentanil reached 2 ng/mL, propofol TCI induction was started. Anaesthesia induction commenced in the Marsh group at a target plasma concentration (Cpt) of 2 µg/mL, whereas it started in the Schnider group at a target effect-site concentration (Cet) of 2 µg/mL. If induction was delayed after 3 min, the target concentration (Ct) was gradually increased to 0.5 µg/mL every 30 sec until successful induction. The Ct at successful induction, induction time, Ce at successful induction and haemodynamic parameters were recorded.Results

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Efficacy of intraoperative dexmedetomidine infusion on emergence agitation and quality of recovery after nasal surgery

Abstract: Intraoperative infusion of dexmedetomidine provided smooth and haemodynamically stable emergence. It also improved quality of recovery after nasal surgery.

Cited by 145 publications

References 22 publications

Efficacy of a single dose of dexmedetomidine for cough suppression during anesthetic emergence: a randomized controlled trial

Efficacy of a single dose of dexmedetomidine for cough suppression during anesthetic emergence: a randomized controlled trial

Effect of Dexmedetomidine on Emergence Agitation after Nasal Surgeries

Comparison of the Effects of Dexmedetomidine on the Induction of Anaesthesia Using Marsh and Schnider Pharmacokinetic Models of Propofol Target-Controlled Infusion

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