A Comparison of the Effects of Dexmedetomidine and Propofol in Controlling the Hemodynamic Responses after Intubation: A Double-Blind, Randomized, Clinical Trial Study
Keywords:Dexmedetomidine; Propofol, Hemodynamic responses, intubation
AIM: This study aimed to compare the effects of dexmedetomidine and propofol in controlling the hemodynamic response following intubation of patientsâ€™ candidate intubation in the emergency department
METHODS: A total of 114 patients were randomly assigned to one of 2 groups to receive one of the following treatments: dexmedetomidine 0.4 Âµg/kg (Group D, n = 57) and propofol 1â€“1.5â€‰mg/kg/h (Group P, n = 57). Hemodynamic data such as the systolic blood pressure, diastolic blood pressure, arterial oxygen saturation and heart rate (HR) were recorded from the entrance to operation room to 5, 10 and 15 min after tracheal intubation
RESULTS: Compared with group D, group P exhibited increases in mean arterial blood pressure (MAP), and systolic blood pressure significantly at all times and immediately after the endotracheal intubation. Moreover, the mean diastolic blood pressure changes due to tracheal intubation in group P were significantly more than group D immediately after the intubation. Furthermore, the mean heart rate changes immediately and 5 min after tracheal intubation was significantly higher in group P
CONCLUSION: Our data suggest that the benefits of dexmedetomidine more than propofol in hemodynamic stability because propofol was associated with more variability in systolic/diastolic blood pressure, HR and MAP after endotracheal intubation.
Plum Analytics Artifact Widget Block
Kovac A. Controlling the hemodynamic response to laryngoscopy and endotracheal intubation. J Clin Anesth. 1996; 8(8):63-79. https://doi.org/10.1016/0952-8180(95)00147-6
Crawford D, Fell D, Achola K, Smith G. Effect of alfentanil on the presser and catecholamine responses to tracheal intubation. Br J Anaesth. 1987; 59(6):707-12. https://doi.org/10.1093/bja/59.6.707 PMid:3111508
Stoelting R. Attenuation of blood pressure response to laryngoscopy and tracheal intubation with sodium nitropruside. Anesth Analg. 1979; 58(2):116-9. https://doi.org/10.1213/00000539-197903000-00011 PMid:571234
Vucevic M, Purdy G, Ellis F. Esmolol hydrochloride for the management of the cardiovascular stress response to laryngoscopy and tracheal intubation. Br J Anaesth. 1992; 68(5):529-30. https://doi.org/10.1093/bja/68.5.529 PMid:1642945
Curran J, Crowley M, O'Sullivan G. Droperidol and endotracheal intubation. Anaesthesia. 1980; 35(3):290-4. https://doi.org/10.1111/j.1365-2044.1980.tb05099.x PMid:7396141
Taittonen M, Kirvela O. Cardiovascular and metabolic response to clonidine and midazolam premedication. Eur J Anaesthesia. 1997; 14(2):190-6.
Miller R, Reves J, Glass P, Lubarsky D, McEvoy M. Intravenous non-opioid anaesthetics. Miller's Anaesthesia. Philadelphia: Elsevier Churchill Livingstone, 2015.
Saricaoglu F, Uzun S, Arun O, Arun F, Aypar U. A clinical comparison of etomidate-lipuro, propofol and admixture at induction. Saudi J Anaesth. 2011; 5:62-6. https://doi.org/10.4103/1658-354X.76509 PMid:21655019 PMCid:PMC3101756
Weisenberg M, Sessler D, Tavdi M, Gleb M, Ezri T, Dalton J, et al. Dose-dependent hemodynamic effects of propofol induction following brotizolam premedication in hypertensive patients taking angiotensin-converting enzyme inhibitors. J Clin Anesth. 2010; 22:190-5. https://doi.org/10.1016/j.jclinane.2009.07.008 PMid:20400005
Reagh O, Torres H, RodrÃguez N, Gatica S. Alpha-2B adrenergic receptor mediated hemodynamic profile of etomidate. R Health Sci J. 2010; 29:91-5.
Sarkar M, Laussen P, Zurakowski D, Shukla A, Kussman B, Odegard K. Hemodynamic responses to etomidate on induction of anesthesia in pediatric patients. Anesth Analg. 2005; 101:645-50. https://doi.org/10.1213/01.ane.0000166764.99863.b4 PMid:16115968
Savola J, Ruskoaho H, Puurunen J, Salonen J, KÃ¤rki N. Evidence for medetomidine as a selective and potent agonist at alpha 2-adrenoreceptors. J Auton Pharmacol. 1986; 6(3):275-84. https://doi.org/10.1111/j.1474-8673.1986.tb00654.x PMid:2880852
Ebert T, Hall J, Barney J, Uhrich T, Colinco M. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000; 93(6):382-94. https://doi.org/10.1097/00000542-200008000-00016 PMid:10910487
Gurbet A, Basagan-Mogol E, Turker G, Ugun F, Kaya F, Ozcan B. Intraoperative infusion of dexmedetomidine reduces perioperativeanalgesic requirements. Can J Anaesth. 2006; 53(5):646-52. https://doi.org/10.1007/BF03021622 PMid:16803911
Hall J, Uhrich T, Barney J, Arain S, Ebert T. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg. 2000; 90(5):699-705. https://doi.org/10.1097/00000539-200003000-00035 PMid:10702460
Blaudszun G, Lysakowski C, Elia N, Tramer M. Effect of perioperative systemic alpha2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials. Anesthesiology. 2012; 116(4):1312-22. https://doi.org/10.1097/ALN.0b013e31825681cb PMid:22546966
Bekker A, Haile M, Kline R, Didehvar S, Babu R, Martiniuk F, et al. The effect of intraoperative infusion of dexmedetomidine on the quality of recovery after major spinal surgery. J Neurosurg Anesthesiology. 2013; 25(1):16-24. https://doi.org/10.1097/ANA.0b013e31826318af PMid:22824921 PMCid:PMC3557800
Sivilotti M, Ducharme J. Randomized double blind study on sedative and hemodynamics during rapid sequence intubation in the emergency department: The Shred study. Ann Emerg Mwd. 1998; 31(3):313-24. https://doi.org/10.1016/S0196-0644(98)70341-5
Yazdi B, Khalili M, Talebi H, Fotovat A, Nikaeen A. Effect of adding ketamine to propofol infusion on hemodynamics and recovery time of patients under cataract surgery. Anesthesiology and Pain. 2011; 1(4).
Chalam K. A comparative study of intravenous dexmedetomidine-versus propofol-based sedation for awake fiberoptic intubation along with airway blocks in cervical discectomy patients. Karnataka Anaesthesia Journal. 2015; 1(1):21-7. https://doi.org/10.4103/2394-6954.149716
Bollucuoglu K, Hanci V, Yurtlu S, Okyay D, Ayoglu H, Turan I. Comparison of propofol-dexmedetomidine, tiopental-dexmedetomidine and etomidate-dexmedetomidine combinations' effects on the tracheal intubation conditions without using muscle relaxants. Bratisl Lek Listy. 2013; 114(9):514-8. https://doi.org/10.4149/BLL_2013_107
Cheng S, Hu d, Hei G. Comparision Dexmedetomidin and propofol in hyeamodynamic response in children with cardiovascular disease in heart surgery. Anesthesiology. 2014.
Karimian M, Emadi S, Nasiri E, Farzin D. Comparision of the effects of different doses of ketamine propofol on heamodynamic chandes of the patients during induction of anesthesia J Mazandaran UnivMed Sci. 2006; 16(54):7-13.
How to Cite
Copyright (c) 2018 Alireza Kamali, Mehrdad Taghizadeh, Mohtaram Esfandiar, Amin Shams Akhtari
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All rights reserved.