Key result
Dexmedetomidine reduces mean arterial pressure during double-lumen intubation by ~14 mmHg vs. placebo.
Why the study?
Does prophylactic dexmedetomidine attenuate hemodynamic responses to double-lumen endotracheal intubation in patients undergoing thoracic surgery?
RCT (n=60)
Double-blind
Block of four randomizations
No
Does prophylactic dexmedetomidine attenuate hemodynamic responses to double-lumen endotracheal intubation in patients undergoing thoracic surgery?
Mean Difference: 15.2
Number Needed to Treat: 10
p-value: p=<0.001
Prophylactic administration of dexmedetomidine effectively blunts the hemodynamic stress response to double-lumen endotracheal intubation.
Supports prophylactic dexmedetomidine before double-lumen intubation in thoracic surgery; extends RCT evidence for its use in airway management.
The purpose of this study was to determine the effect of dexmedetomidine on hemodynamic responses to DLT intubation compared to placebo and to assess the adverse effects related to dexmedetomidine. Sixty patients were randomly allocated to receive 0.7 μ g/kg dexmedetomidine (n = 30) or normal saline (n = 30) 10 minutes before general anesthesia. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and rate pressure product (RPP) between groups were recorded. During intubation and 10 minutes afterward (T1-T10), the mean SBP, DBP, MAP, HR, and RPP in the control group were significantly higher than those in the dexmedetomidine group throughout the study period except at T1. The mean differences of SBP, DBP, MAP, HR, and RPP were significantly higher in the control group, with the value of 15.2 mmHg, 10.5 mmHg, 14 mmHg, 10.5 beats per minute, and 2,462.8 mmHg min(-1). Four patients in the dexmedetomidine group and 1 patient in the control group developed hypotension, while 2 patients in the dexmedetomidine group had bradycardia. Prophylactic dexmedetomidine can attenuate the hemodynamic responses to laryngoscopy and DLT intubation with minimal adverse effects. This trial is registered with ClinicalTrials.gov NCT01289769.
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Pipanmekaporn et al. (2013) conducted an RCT in Scheduled thoracic surgery requiring double-lumen endotracheal intubation (n=60). Dexmedetomidine vs. Normal saline (0.9% NaCl 20 mL) was evaluated on Differences in hemodynamic parameters between groups during intubation and 10 minutes afterward (MD for SBP 15.2 mmHg, MAP 14 mmHg, p=<0.001). Prophylactic dexmedetomidine 0.7 μg/kg significantly attenuated hemodynamic responses to double-lumen endotracheal intubation, reducing mean arterial pressure by 14 mmHg compared to placebo (p<0.001).
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