Comparison of Dexmedetomidine and Remifentanil on Airway Reflex and Hemodynamic Changes during Recovery after Craniotomy

Hyunzu Kim; Kyeong Tae Min; Jeong Rim Lee; Sang Hee Ha; Woo Kyung Lee; Jae Hee Seo; Seung Ho Choi

doi:10.3349/ymj.2016.57.4.980

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Comparison of Dexmedetomidine and Remifentanil on Airway Reflex and Hemodynamic Changes during Recovery after Craniotomy

Journal article

Peer reviewed

Comparison of Dexmedetomidine and Remifentanil on Airway Reflex and Hemodynamic Changes during Recovery after Craniotomy

Hyunzu Kim, Kyeong Tae Min, Jeong Rim Lee, Sang Hee Ha, Woo Kyung Lee, Jae Hee Seo and Seung Ho Choi

Yonsei medical journal, Vol.57(4), pp.980-986

07/01/2016

DOI: 10.3349/ymj.2016.57.4.980

PMCID: PMC4951478

PMID: 27189295

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Abstract

During emergence from anesthesia for a craniotomy, maintenance of hemodynamic stability and prompt evaluation of neurological status is mandatory. The aim of this prospective, randomized, double-blind study was to compare the effects of dexmedetomidine and remifentanil on airway reflex and hemodynamic change in patients undergoing craniotomy. Seventy-four patients undergoing clipping of unruptured cerebral aneurysm were recruited. In the dexmedetomidine group, patients were administered dexmedetomidine (0.5 μg/kg) for 5 minutes, while the patients of the remifentanil group were administered remifentanil with an effect site concentration of 1.5 ng/mL until endotracheal extubation. The incidence and severity of cough and hemodynamic variables were measured during the recovery period. Hemodynamic variables, respiration rate, and sedation scale were measured after extubation and in the post-anesthetic care unit (PACU). The incidence of grade 2 and 3 cough at the point of extubation was 62.5% in the dexmedetomidine group and 53.1% in the remifentanil group (p=0.39). Mean arterial pressure (p=0.01) at admission to the PACU and heart rate (p=0.04 and 0.01, respectively) at admission and at 10 minutes in the PACU were significantly lower in the dexmedetomidine group. Respiration rate was significantly lower in the remifentanil group at 2 minutes (p<0.01) and 5 minutes (p<0.01) after extubation. We concluded that a single bolus of dexmedetomidine (0.5 μg/kg) and remifentanil infusion have equal effectiveness in attenuating coughing and hemodynamic changes in patients undergoing cerebral aneurysm clipping; however, dexmedetomidine leads to better preservation of respiration.

Adult

Aged

Airway Extubation

Anesthesia Recovery Period

Cough - drug therapy

Craniotomy - adverse effects

Dexmedetomidine - pharmacology

Dexmedetomidine - therapeutic use

Double-Blind Method

Female

Hemodynamics - drug effects

Humans

Male

Middle Aged

Piperidines - pharmacology

Piperidines - therapeutic use

Prospective Studies

Reflex - drug effects

Respiratory System - blood supply

Respiratory System - drug effects

Respiratory System - physiopathology

Young Adult

Details

Title: Subtitle: Comparison of Dexmedetomidine and Remifentanil on Airway Reflex and Hemodynamic Changes during Recovery after Craniotomy
Creators: Hyunzu Kim - Hallym University
Kyeong Tae Min - Yonsei University
Jeong Rim Lee - Yonsei University
Sang Hee Ha - Yonsei University
Woo Kyung Lee - Yonsei University
Jae Hee Seo - Yonsei University
Seung Ho Choi - Yonsei University
Resource Type: Journal article
Publication Details: Yonsei medical journal, Vol.57(4), pp.980-986
DOI: 10.3349/ymj.2016.57.4.980
PMID: 27189295
PMCID: PMC4951478
NLM abbreviation: Yonsei Med J
ISSN: 0513-5796
eISSN: 1976-2437
Language: English
Date published: 07/01/2016
Academic Unit: Anesthesia
Record Identifier: 9984806501102771

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