Tingjie Liu1, Minju Qin, Wenxian Li, Xia Shen. 1. Department of Anesthesiology, The Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
Abstract
OBJECTIVES: To investigate whether a single dose of dexmedetomidine (DEX) improves surgical field visibility. STUDY DESIGN: Randomized, prospective, double-blind study. SETTING: Tertiary teaching hospital. INTERVENTIONS:ASA I or II patients undergoing tympanoplasty with ossiculoplasty were randomly assigned to receive either 0.8 μg/kg DEX (Group D) or the same volume of saline (Group N) 10 min before anesthesia induction. MAIN OUTCOMES: The primary outcome was the visibility of the surgical field rated by surgeons by Boezaart score. The secondary outcomes were consumption of anesthesia, hemodynamic profiles, and subsequent recovery. RESULTS:Boezaart scores for surgical visibility were lower in Group D than in Group N (1.3 ± 0.8 versus 1.8 ± 0.9, P = 0.014). Minimum alveolar concentrations of sevoflurane (Group D 1 [0.9/1.1] versus Group N 1 [1/1.2], P = 0.018) and remifentanil consumption (Group D 370 [218/504] μg versus Group N 583 [300/1028] μg, P = 0.002) were less in Group D. Except for a transient increase in blood pressure and a decrease in heart rate during DEX infusion, hemodynamic profiles were more stable in Group D than in Group N. More patients needed morphine rescue and presented with postoperative nausea and vomiting in Group N than in Group D (Group D 1 versus Group N 8, P = 0.029). Recovery time was comparable between the two groups (Group D 19 min versus Group N 18 min, P = 0.569). CONCLUSION: Use of a single dose of DEX resulted in improved surgical visibility, less consumption of anesthesia, and more favorable hemodynamic profile while not delaying recovery time.
RCT Entities:
OBJECTIVES: To investigate whether a single dose of dexmedetomidine (DEX) improves surgical field visibility. STUDY DESIGN: Randomized, prospective, double-blind study. SETTING: Tertiary teaching hospital. INTERVENTIONS:ASA I or II patients undergoing tympanoplasty with ossiculoplasty were randomly assigned to receive either 0.8 μg/kg DEX (Group D) or the same volume of saline (Group N) 10 min before anesthesia induction. MAIN OUTCOMES: The primary outcome was the visibility of the surgical field rated by surgeons by Boezaart score. The secondary outcomes were consumption of anesthesia, hemodynamic profiles, and subsequent recovery. RESULTS: Boezaart scores for surgical visibility were lower in Group D than in Group N (1.3 ± 0.8 versus 1.8 ± 0.9, P = 0.014). Minimum alveolar concentrations of sevoflurane (Group D 1 [0.9/1.1] versus Group N 1 [1/1.2], P = 0.018) and remifentanil consumption (Group D 370 [218/504] μg versus Group N 583 [300/1028] μg, P = 0.002) were less in Group D. Except for a transient increase in blood pressure and a decrease in heart rate during DEX infusion, hemodynamic profiles were more stable in Group D than in Group N. More patients needed morphine rescue and presented with postoperative nausea and vomiting in Group N than in Group D (Group D 1 versus Group N 8, P = 0.029). Recovery time was comparable between the two groups (Group D 19 min versus Group N 18 min, P = 0.569). CONCLUSION: Use of a single dose of DEX resulted in improved surgical visibility, less consumption of anesthesia, and more favorable hemodynamic profile while not delaying recovery time.