The effect of prophylactic dexmedetomidine on hemodynamic disturbances to double-lumen endotracheal intubation: a prospective, randomized, double-blind, and placebo-controlled trial

Tanyong Pipanmekaporn, Yodying Punjasawadwong, Somrat Charuluxananan, Worawut Lapisatepun, Pavena Bunburaphong, Tanyong Pipanmekaporn, Yodying Punjasawadwong, Somrat Charuluxananan, Worawut Lapisatepun, Pavena Bunburaphong

Abstract

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.

Figures

Figure 1
Figure 1
The Consolidated Standards of Reporting Trials flow diagram of the study.
Figure 2
Figure 2
A line graph demonstrated the mean SBP and their standard deviation comparing groups at different time points. Baseline refers to the point of time before the study drug is administered. Before intubation refers the point of time after anesthetic induction just before DLT intubation. T0 is the period during intubation. T1–T10 refer the points of time as minutes after intubation. SBP: systolic blood pressure. +P value < 0.05 compared between groups. ΔP value < 0.05, significant difference compared with baseline in the control group. ×P value < 0.05, significant difference compared with baseline in the dexmedetomidine group.
Figure 3
Figure 3
A line graph demonstrated the mean DBP and their standard deviation comparing groups at different time points. Baseline refers to the point of time before the study drug is administered. Before intubation refers the point of time after anesthetic induction just before DLT intubation. T0 is the period during intubation. T1–T10 refer the points of time as minutes after intubation. DBP: diastolic blood pressure. +P value < 0.05 compared between groups. ΔP value < 0.05, significant difference compared with baseline in the control group. ×P value < 0.05, significant difference compared with baseline in the dexmedetomidine group.
Figure 4
Figure 4
A line graph demonstrated the mean MAP and their standard deviation comparing groups at different time points. Baseline refers to the point of time before the study drug is administered. Before intubation refers the point of time after anesthetic induction just before DLT intubation. T0 is the period during intubation. T1–T10 refer the points of time as minutes after intubation. MAP: mean arterial pressure. +P value < 0.05 compared between groups. ΔP value < 0.05, significant difference compared with baseline in the control group. ×P value < 0.05, significant difference compared with baseline in the dexmedetomidine group.
Figure 5
Figure 5
A line graph demonstrated the mean HR and their standard deviation comparing groups at different time points. Baseline refers to the point of time before the study drug is administered. Before intubation refers the point of time after anesthetic induction just before DLT intubation. T0 is the period during intubation. T1–T10 refer the points of time as minutes after intubation. HR: heart rate. +P value < 0.05 compared between groups. ΔP value < 0.05, significant difference compared with baseline in the control group. ×P value < 0.05, significant difference compared with baseline in the dexmedetomidine group.

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