Dexmedetomidine versus midazolam on cough and recovery quality after partial and total laryngectomy – a randomized controlled trial

Autor:	Wen Xian Li, Rui Xu, Jie Jia, Yi Lu, Yun Zhu
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Adult Male genetic structures Visual analogue scale medicine.medical_treatment Midazolam Recovery quality Laryngectomy 030204 cardiovascular system & hematology Pacu lcsh:RD78.3-87.3 03 medical and health sciences Postoperative Complications 0302 clinical medicine Double-Blind Method Heart rate medicine Humans Hypnotics and Sedatives Prospective Studies 030212 general & internal medicine Dexmedetomidine Aged biology medicine.diagnostic_test business.industry Middle Aged biology.organism_classification Pulse oximetry Anesthesiology and Pain Medicine Blood pressure Cough lcsh:Anesthesiology Anesthesia Anesthesia Recovery Period business psychological phenomena and processes Research Article medicine.drug
Zdroj:	BMC Anesthesiology, Vol 20, Iss 1, Pp 1-8 (2020) BMC Anesthesiology
ISSN:	1471-2253
Popis:	Background During emergence from anesthesia after partial and total laryngectomy, excessive airway reflex and systemic hypertension may lead to subcutaneous emphysema, hemorrhage or pneumothorax. Methods American Society of Anesthesiologist physical status III and IV male adults undergoing elective laryngectomy were recruited and randomly allocated to receive either dexmedetomidine (group D) or midazolam (group M). The primary outcome was incidence and severity of cough. Pulse oximetry results (SpO2), heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were also recorded. The visual analog scale and the Ramsay sedation scale were recorded at the points of wakefulness and departure from the post-anesthesia care unit (PACU). Rescue analgesia consumption, the time of spontaneous breath recovery, duration of the PACU stay, and the incidence of adverse effects were also recorded. Results The prevalence of no coughing was significantly higher in group D than in group M at the points of wakefulness and departure. HR, SBP, and DBP were significantly lower in group D compared with group M, and SpO2 was significantly higher in group D than in group M at the moment of laryngectomy. Pain scores were lower in group D than in group M. The Ramsay score at the point of wakefulness was higher in group D than in group M. There was no difference in time to spontaneous breathing recovery, duration of the PACU stay, and incidence of adverse effects. Conclusions Compared with midazolam, dexmedetomidine is an effective alternative to attenuate coughing and hemodynamic changes with a low incidence of adverse events during emergence from anesthesia after partial and total laryngectomy. Trial registration NCT03918889, registered at clinicaltrials.gov, date of registration: March 28, 2019.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8aacbbeec77b0ba58544309e72b5ea4b http://link.springer.com/article/10.1186/s12871-020-01168-7 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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