Sedation Effect of Dexmedetomidine Alone and Its Effects on Respiration and Circulation and Complications in Transtracheal Endoscopic Interventional Therapy_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 GuoGuohua , XiaoJianhong , PengJinyun , SongBin

Department of Respiratory Medicine, Fujian Medical University Affiliated Mindong Hospital, Fu'an, Fujian, 355000, China;

Corresponding?author：

GuoGuohua, Email: 277681575@qq.com

Keywords：

Midazolam; Fentanyl; Dexmedetomidine; Bronchoscopy

DOI：

10.7507/1671-6205.2015051

Video：

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Objective To explore sedation effect of dexmedetomidine alone and its effects on respiration and circulation of complications in transtracheal endoscopic interventional therapy. Methods From April 2012 to May 2014, 60 adult patients who plan to undergo transtracheal endoscopic interventional therapy were recruited in the study. The patients were divided into a midazolam combined with fenanyl citrate intravenous injection group (MF group), and a dexmedetomidine target controlled infusion group (Y group) using the method of random number table, with 30 cases in each group. All patients were given 2% lidocaine 15 mL by ultrasonic atomizing inhalation for local surface anaesthesia preoperatively, and then the patients in MF group received midazolam and fentanyl citrate by slow intravenous injection, the patients in Y group received dexmedetomidine 0.5 g intravenous injection and persistant infusion of dexmedetomidinein dosage of 0.2 μg/h. The basic Ramsay sedation score (T0) was recorded, then the Ramsay sedation scoring was conducted when the bronchoscope entering into the pharyngeal cavity (T1), into the glottis (T2), and into the bronchial (T3), respectively. Results There were no significant differences in restlessness, hypotension, hypertension, or tachycardia incidence rate between two groups (P>0.05). The differences in Ramsay score between two groups was not significant at T0 or T1 time point (P>0.05), but was significant at T2 and T3 time point (P<0.05). Compared with MF group, the incidence of respiratory depression and hypoxemia was significantly lower, and the recovery time was significantly shorter in Y group (P<0.05). All patients in Y group woke up immediately by simple call. While in MF group, 23 patients needed intravenous flumazenil to promote awakening. Conclusion Dexmedetomidine alone can provide effective sedation in transtracheal endoscopic interventional therapy with good effect, high safety, and more convenient awakening.

Citation： GuoGuohua, XiaoJianhong, PengJinyun, SongBin. Sedation Effect of Dexmedetomidine Alone and Its Effects on Respiration and Circulation and Complications in Transtracheal Endoscopic Interventional Therapy. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(2): 201-203. doi: 10.7507/1671-6205.2015051 Copy

1.	?李昭,劉琨鵬,李成輝.纖維支氣管鏡檢查鎮靜藥物的選擇.臨床麻醉學雜志,2011,27:515-517.
2.	徐雪,梁治,董秋月,等.右美托咪定對困難氣道患者經鼻插管應激反應的影響.臨床麻醉學雜志,2011,27:1235-1236.
3.	尹衛國. 右美托嘧啶與舒芬太尼輔助表面麻醉減輕清醒患者纖支鏡氣管插管反應的效果對比研究.現代中西醫結合雜志,2013,22:1898-1899.
4.	Dutau H, Vandemoortele T, Breen D. Rigid bronchoscopy. Clin Chest Med,2013,34:427-435.
5.	Fadaizadeh L,Hosseini MS. Laryngeal mask airway in interventional bronchoscopy for tracheal lesions. Acta Anaesthesiol Taiwan,2013,51:137.
6.	Evered L, Scott DA, Silbert B, et al. Postoperative cognitive dysfunction is independent of type of surgery and anesthetic. Anesthesia Analgesia,2011,112:1179-1185.
7.	Papathanakos G, Pouagare M, Tzimas P, et al. The impact of ondansetron on postoperative cognitive function in elderly patients undergoing surgery under general anaesthesia due to femoral fracture-preliminary data:1AP9-6. Eur J Anaesthesiol,2012,29:29.
8.	Le Freche H, Brouillette J, Fernandez-Gomez FJ, et al. Tau phosphorylation and sevoflurane anesthesia:an association to postoperative cognitive impairment. Anesthesiology,2012,116:779-787.
9.	Van Harten AE, Scheeren TWL, Absalom AR. A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia. Anaesthesia,2012,67:280-293.
10.	An J, Fang Q, Huang C, et al. Deeper total intravenous anesthesia reduced the incidence of early postoperative cognitive dysfunction after microvascular decompression for facial spasm. J Neurosurg Anesthesiol,2011,23:12-17.
11.	Monk TG, Price CC. Postoperative cognitive disorders. Curr Opin Crit Care,2011,17:32-34.
12.	Schoen J, Husemann L, Tiemeyer C, et al. Cognitive function after sevoflurane-vs propofol-based anaesthesia for on-pump cardiac surgery:a randomized controlled trial. Br J Anaesth,2011,106:840-850.
13.	Jildenst?l PK, Hallén JL, Rawal N, et al. Effect of auditory evoked potential-guided anaesthesia on consumption of anaesthetics and early postoperative cognitive dysfunction:a randomised controlled trial. Eur J Anaesthesiol,2011,28:213-219.
14.	胡憲文,張野,孔令鎖,等.不同劑量右美托嘧啶抑制氣管插管誘發患者心血管反應效應的比較.中華麻醉學雜志,2010,30:992-995.
15.	張偉,張加強,孟凡民,等.小同負荷劑量右旋美托咪定對成人行清醒氣管插管的影響.中華實用診斷與治療雜志,2011,25:1075-1077.

1. ?李昭,劉琨鵬,李成輝.纖維支氣管鏡檢查鎮靜藥物的選擇.臨床麻醉學雜志,2011,27:515-517.
2. 徐雪,梁治,董秋月,等.右美托咪定對困難氣道患者經鼻插管應激反應的影響.臨床麻醉學雜志,2011,27:1235-1236.
3. 尹衛國. 右美托嘧啶與舒芬太尼輔助表面麻醉減輕清醒患者纖支鏡氣管插管反應的效果對比研究.現代中西醫結合雜志,2013,22:1898-1899.
4. Dutau H, Vandemoortele T, Breen D. Rigid bronchoscopy. Clin Chest Med,2013,34:427-435.
5. Fadaizadeh L,Hosseini MS. Laryngeal mask airway in interventional bronchoscopy for tracheal lesions. Acta Anaesthesiol Taiwan,2013,51:137.
6. Evered L, Scott DA, Silbert B, et al. Postoperative cognitive dysfunction is independent of type of surgery and anesthetic. Anesthesia Analgesia,2011,112:1179-1185.
7. Papathanakos G, Pouagare M, Tzimas P, et al. The impact of ondansetron on postoperative cognitive function in elderly patients undergoing surgery under general anaesthesia due to femoral fracture-preliminary data:1AP9-6. Eur J Anaesthesiol,2012,29:29.
8. Le Freche H, Brouillette J, Fernandez-Gomez FJ, et al. Tau phosphorylation and sevoflurane anesthesia:an association to postoperative cognitive impairment. Anesthesiology,2012,116:779-787.
9. Van Harten AE, Scheeren TWL, Absalom AR. A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia. Anaesthesia,2012,67:280-293.
10. An J, Fang Q, Huang C, et al. Deeper total intravenous anesthesia reduced the incidence of early postoperative cognitive dysfunction after microvascular decompression for facial spasm. J Neurosurg Anesthesiol,2011,23:12-17.
11. Monk TG, Price CC. Postoperative cognitive disorders. Curr Opin Crit Care,2011,17:32-34.
12. Schoen J, Husemann L, Tiemeyer C, et al. Cognitive function after sevoflurane-vs propofol-based anaesthesia for on-pump cardiac surgery:a randomized controlled trial. Br J Anaesth,2011,106:840-850.
13. Jildenst?l PK, Hallén JL, Rawal N, et al. Effect of auditory evoked potential-guided anaesthesia on consumption of anaesthetics and early postoperative cognitive dysfunction:a randomised controlled trial. Eur J Anaesthesiol,2011,28:213-219.
14. 胡憲文,張野,孔令鎖,等.不同劑量右美托嘧啶抑制氣管插管誘發患者心血管反應效應的比較.中華麻醉學雜志,2010,30:992-995.
15. 張偉,張加強,孟凡民,等.小同負荷劑量右旋美托咪定對成人行清醒氣管插管的影響.中華實用診斷與治療雜志,2011,25:1075-1077.

Chinese Journal of Respiratory and Critical Care Medicine

Sedation Effect of Dexmedetomidine Alone and Its Effects on Respiration and Circulation and Complications in Transtracheal Endoscopic Interventional Therapy

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