A randomised controlled trial of dexmedetomidine for suspension laryngoscopy

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Abstract

Summary

We randomly allocated 80 patients to intravenous dexmedetomidine (0.25, 0.5, or 1 μg.kg−1) or placebo 15 min before anaesthetic induction. Dexmedetomidine 0.5 and 1.0 μg.kg−1 significantly reduced the mean (95% CI) propofol effect-site concentrations by 0.83 (0.63–1.03) μg.ml−1, p = 0.001 and 1.29 (1.12–1.46) μg.ml−1, p = 0.0003 at intubation, by 1.05 (0.85–1.25 μg.ml−1, p = 0.0006 and 1.33 (1.15–1.51) μg.ml−1, p = 0.0002 when surgery started, and by 0.59 (0.39–0.79) μg.ml−1, p = 0.030 and 0.72 (0.57–0.87) μg.ml−1, p = 0.004 on completion of surgery, respectively. Patients’ tracheas were extubated sooner after 0.5 and 1.0 μg.kg−1 dexmedetomidine, by 5.36 (2.39–8.32) min, p = 0.009 and 7.37 (3.24–11.51) min p = 0.003, respectively. Tachycardic responses to intubation were present in five placebo patients and no dexmedetomidine patients. Bradycardia was treated after dexmedetomidine in six patients: five after 1.0 μg.kg−1; and one after 0.25 μg.kg−1. Single-dose dexmedetomidine can reduce anaesthetic requirements, with both desirable and undesirable haemodynamic effects.

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