Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients?

BMC Anesthesiology

Gulbin Sezen²  Yavuz Demiraran²  Ilknur Suidiye Seker²  Ibrahim Karagoz²  Abdulkadir Iskender²  Handan Ankarali¹  Ozlem Ersoy²  Onur Ozlu² 

[1] Department of Biostatistics, Duzce University Faculty of Medicine, Duzce, Turkey

[2] Department of Anesthesiology and Reanimation, Duzce University Faculty of Medicine, Duzce, Turkey

关键词: Hypertension;    Premedication;    Midazolam;    Dexmedetomidine;   

Others  :  1084227
DOI  :  10.1186/1471-2253-14-113

 received in 2014-09-11, accepted in 2014-11-25,  发布年份 2014

【 摘 要 】

Background

Perioperative hemodynamic fluctuations are seen more often in hypertensive patients than in normotensive patients. The purpose of our study was to investigate the perioperative hemodynamic effects of dexmedetomidine and midazolam used for premedication in hypertensive patients relative to each other and in comparison to normotensive patients.

Methods

One-hundred-forty female, normotensive or hypertensive patients undergoing myomectomies or hysterectomies. They were randomly enrolled into the subgroups: Group ND (normotensive-dexmedetomidine); Group HD (hypertensive-dexmedetomine); Group NM (normotensive-midazolam); Group HM (hypertensive- midazolam). Dexmedetomidine was administered at a concentration of 0.5 μg.kg⁻¹, and midazolam was administered at a concentration of 0.025 μg.kg⁻¹ via intravenous (IV) infusion before the induction of anaesthesia. Haemodynamic parameters were recorded at several times (T_beginning, T_{preop5 min}, T_{preop 10 min}, T_induction, T_intubation, T_{intubation5 min}, T_{initial surgery}, T_{surgery 15 min}, T_{surgery 30 min}, T_extubation, T_{extubation 5 min}). Propofol amount for induction, time between induction and initial surgery, demand of antihypertensive therapy, rescue atropine were recorded. Quantitative clinical and demographic characteristics were compared using One Way ANOVA. The values were compared using One-way Analysis of Variance. Additionally periodic variations were examined by One way Repeated Measures Analysis of Variance for groups separately.

Results

SBP was significantly different between normotensive and hypertensive groups at the following time points: T_{preop 5 min}, T_{preop 10 min}, T_induction, T_intubation, T_{intubation 5 min} and T_{initial surgery}. MBP was significantly different in the hypertensive groups at T_induction, T_intubation, T_{intubation 5 min,} T_{initial surgery}, T_{surgery 15 min}, T_{surgery 30 min,} T_extubation and T_{extubation 5 min}. The perioperative requirements for antihypertensive drugs were significantly higher in Group HM.

Conclusion

In the hypertensive patients, dexmedetomidine premedication provides better hemodynamic stability compared with midazolam, and because it decreases the antihypertensive requirements, its use might be beneficial.

Trial registration

Trial registration: Clinicaltrials.gov identifier: NCT02058485.

【 授权许可】

   
2014 Sezen et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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