Dexmedetomedine Premedication Use in Direct Laryngoscopic Surgery to Attenuate Hemodynamic Adverse Effects: A Clinical Comparative Study
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- Category: Vol. 85, June 2017
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Dexmedetomedine Premedication Use in Direct Laryngoscopic Surgery to Attenuate Hemodynamic Adverse Effects: A Clinical Comparative Study, IMAN R.M. ABDEL AAL, SAHAR M. ELSHAL, HEBA I. NAGY and RAMY M. FEKRY
Abstract
Background: Direct laryngoscopy is a surgical procedures associated with stress response inducing hemodynamic unsta-bility as it involve severe sympathetic stimulation. Modern anesthesia practices aim to prevent sympathetic discharge and provide hemodynamic stability.
Objective: Comparing the hemodynamic effects of dexme-detomedine versus midazolam as premedicants in direct laryngoscopic surgery.
Patients and Methods: Eighty adult patients of American society of anesthesiologists physical class I (ASA I), aged 20-50 years old, were randomly allocated into two equal groups (n=40) each patient received intravenous IV 0.04mg/ kg midazolam (Group M) or IV 1μg/kg dexmedetomidine (group D) over 10 minutes. Perioperative [heart rate HR and mean blood blood pressure MBP], drug side effects and percentage of patients who recieved vasoactive drugs to maintain hemodynamic stability were measured.
Results: No significant difference in demographic data between the two groups. Heart rate HR and mean blood pressure MBP were lower with high significance (p-value <0.001) in group D than groupM throughout the procedure. Intraoperative hypertension was noticed in 40% of patients in group M (p-value <0.001**). Intraoperative tachycardia was recorded in 20% in group M (p-value=.003*). Pre and post operative bradycardia were detected in 4% of patients in group D (p-value=0.040*).
Conclusion: Dexmedetomidine was superior to midazolam in direct laryngoscopic surgeries under general anesthesia. It offered a good control on heart rate and mean arterial pressure in a procedure known to be assossiated with high stress response.