The effect of intranasal dexmedetomidine on hemodynamic disturbances caused by laryngoscopy and endotracheal intubation.

International journal of physiology, pathophysiology and pharmacology Pub Date : 2022-08-15 eCollection Date: 2022-01-01
Seyed Mohammad Reza Safavi, Azim Honarmand, Behzad Nazemroaya, Amir Mohammad Ataie, Zahra Kamran
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Abstract

Background: Induced stimulation while endotracheal intubating affects hemodynamic status. The present study compares the hemodynamic changes caused by endotracheal intubating after administering two doses of intranasal Dexmedetomidine.

Methods: In an experimental (before-after) trial, 88 patients undergoing general anesthesia enrolled in the study. The Iranian Register of Clinical Trial (IRCT) code of the study was IRCT20160307026950N15 (https://en.irct.ir/trial/39269). Patients were allocated to two intervention groups and one control group by random. Intranasal Dexmedetomidine and Normal saline 0.9% were administrated 30 minutes before induction of anesthesia. (1 μg/kg Dexmedetomidine in group 1, 2 μg/kg Dexmedetomidine in group 2 and 1 mg Normal saline 0.9% in group 3). Vital signs and hemodynamic parameters were measured and recorded in minutes 1, 3, 5, and 10th after induction. Data analysis was done by ANOVA and Chi-square tests.

Results: Heart rate, systolic and diastolic blood pressure, and mean arterial pressure were reduced in patients receiving dexmedetomidine (P<0.05), but there were no significant changes in the control group. In arterial oxygenation (P>0.05), there was no significant difference between the three groups in the arterial blood oxygen amount.

Conclusion: Premedication of intranasal dexmedetomidine influences the hemodynamic changes due to anesthesia induction. The dose of 2 µg/kg is better than one µg/kg in improving the hemodynamic state following intubation.

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鼻内右美托咪定对喉镜和气管插管引起的血流动力学紊乱的影响。
背景:气管插管时的诱导刺激影响血流动力学状态。本研究比较了两剂右美托咪定鼻内经气管插管引起的血流动力学变化。方法:在一项实验(前后对照)试验中,88例接受全身麻醉的患者参加了这项研究。本研究的伊朗临床试验注册(IRCT)代码为IRCT20160307026950N15 (https://en.irct.ir/trial/39269)。将患者随机分为两个干预组和一个对照组。麻醉诱导前30分钟鼻内给予右美托咪定和0.9%生理盐水。(1组右美托咪定1 μg/kg, 2组右美托咪定2 μg/kg, 3组生理盐水0.9% 1 mg)。诱导后第1、3、5、10分钟测量生命体征及血流动力学参数。数据分析采用方差分析和卡方检验。结果:右美托咪定治疗组患者心率、收缩压、舒张压、平均动脉压均降低(P0.05),三组动脉血氧量差异无统计学意义。结论:鼻内应用右美托咪定会影响麻醉诱导的血流动力学变化。在改善插管后血流动力学状态方面,2µg/kg的剂量优于1µg/kg的剂量。
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