Key result
Preanesthetic administration of dexmedetomidine at 0.5 μg/kg significantly reduced the time to achieve 90% neuromuscular block compared to placebo (77.8 vs 108.7 seconds, p<0.01) and attenuated hemodynamic responses to intubation.
Why the study?
Does dexmedetomidine improve hemodynamic stability and alter neuromuscular block during endotracheal intubation in patients undergoing elective surgery?
RCT (n=75)
Double-blind
Closed envelope method
No
Does dexmedetomidine improve hemodynamic stability and alter neuromuscular block during endotracheal intubation in patients undergoing elective surgery?
Absolute Event Rate: 77.8% vs 108.7%
p-value: p=<0.01
Preanesthetic dexmedetomidine blunts the hemodynamic response to intubation and accelerates the onset of neuromuscular blockade while prolonging its recovery.
Dexmedetomidine may blunt intubation tachycardia dose-dependently; leaves open neuromuscular effects and routine adoption pending larger trials.
Introduction: In this study, we aim to investigate the effects of two different preanesthetic doses of dexmedetomidine on the hemodynamic response to endotracheal intubation, intubation conditions and neuromuscular block.Methods: Seventy-five ASAI-II patients, aged 18-70 years, who required tracheal intubation for elective surgery were allocated for this study.Before induction, patients were randomly divided into three groups to receive either saline as placebo (20cc) (GroupC), dexmedetomidine 0.5 μg/kg (Group D0.5) or dexmedetomidine 1 μg/kg (Group D1) in a total volume of 20 cc in 10 min.Heart rate(HR) and mean arterial pressure (MAP) were recorded according to the study's measurement time.Time to achieve 90% and 100% neuromuscular block, time to recovery from neuromuscular block 25% (T25), 50% (T50), 75% (T75) and recovery index values were noted.Results: The increases in HR after laryngoscopy and immediately intubation were lower in both groups D than Group C. Values of MAP during laryngoscopy were lower in both Groups D than Group C Times to achieve 90% and 100% neuromuscular block were found significantly lower in dexmedetomidine groups than Group C. Values of T75 and recovery index in Group D 0.5, T25, T50, T75 and recovery index in Group D1 were longer than Group C. Neuromuscular block properties were similar between dexmedetomidine groups.Discussion and Conclusion: We conclude that dexmedetomidine decreased hemodynamic response to endotracheal intubation, especially heart rate dose-dependently, whereas it decreased time to achieve neuromuscular block and increased time to recovery from the neuromuscular block as independent from dose.
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Arzu Yıldırım Ar Yıldırım Ar (2018) conducted an RCT in Elective surgery requiring endotracheal intubation (n=75). Dexmedetomidine vs. Saline placebo was evaluated on Time to achieve 90% neuromuscular block (seconds) (p=<0.01). Preanesthetic administration of dexmedetomidine at 0.5 μg/kg significantly reduced the time to achieve 90% neuromuscular block compared to placebo (77.8 vs 108.7 seconds, p<0.01) and attenuated hemodynamic responses to intubation.
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