Most patients with preoperative varying degrees of stress, anxiety, which makes the stress response in patients and affect the normal conduct of anesthesia and surgery.The sympathetic system hyperexcitability prone to cause adverse cardiovascular events and affect postoperative recovery. However, phenobarbital, as the traditional premedication, has less sedative, weak anxiolytic and other shortcomings. Midazolam accompanied by inhibition of respiration,excessive sedation, easily induced delirium,prolonged recovery time and so on. Dexmedetomidine is a highly selective α2-adrenergic receptor agonist, it has sedative, anxiolytic, no inhibition of respiration, and also colorless, odorless, non-mucosal stimulation, nasal drip ease of administration, patient acceptance, comfortable. Therefore, dexmedetomidine as premedication has certain advantages. The purpose of this research is to study sedative effect, safety and the impact of anesthesia recovery period of intranasal dexmedetomidine premedication for suspension laryngoscopy.
All patients received intranasal dexmedetomidine (1μg.kg-1) or placebo at approximately 45 min before induction of anesthesia.The study drug was prepared in a 1-ml syringe.An equal volume of dexmedetomidine or placebo was dropped into each nostril by a blinded research assistant in the supine position.Automatic sphygmomanometer measure blood pressure.Oxygen saturation and heart rate were measured by a pulse oximeter. Respiratory rate, sedation score and anxiety levels regularly assessed. Patients with general anesthesia, suspension laryngoscopy surgery and postoperative care, standard monitoring are unified.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
81
intranasal dexmedetomidine 1μg.kg-1，0.9% saline was added to make a final volume of 1 mL.all patients received intranasal medication at approximately 45-60 min before induction of anesthesia.
0.9% saline 1 mL all patients received intranasal medication at approximately 45-60 min before induction of anesthesia.
Guangzhou First Municipal People's Hospital
Guangzhou, Guangdong, China
Guangzhou First Municipal People's Hospital
Guangzhou, China
Extubation Time After Intranasal Dexmedetomidine Premedication
The times from stopping anesthetic infusions to adequate ventilation, consciousness and extubation after intranasal dexmedetomidine or placebo administration
Time frame: 1 days
Modified OAA/S Scores of Patients Receiving Intranasal Placebo or Dexmedetomidine
Modified Observer's Assessment of Alertness/Sedation scale (OAA/S) scores and 4 point anxiety score of patients receiving intranasal placebo or dexmedetomidine. Modified Observer's Assessment of Alertness/Sedation Scale: 6 Appears alert and awake, responds readily to name spoken in normal tone 5 Appears asleep but responds readily to name spoken in normal tone 4 Lethargic response to name spoken in normal tone 3 Responds only after name is called loudly or repeatedly 2 Responds only after mild prodding or shaking 1 Does not respond to mild prodding or shaking 0 Does not respond to noxious stimulus.
Time frame: 1 days
Heart Rate (HR) of Patients Receiving Intranasal Placebo or Dexmedetomidine
Heart rate (HR) of patients receiving intranasal placebo or dexmedetomidine. HR was monitored in the study.
Time frame: 1 day
Number of Participants With Anxiety Score >2
satisfaction using a 3-point satisfaction score (1 = highly satisfactory, 2 = acceptable, and 3 = unacceptable) anxiety levels using a 4-point anxiety score (1 = combative, 2 = anxious, 3 = calm, and 4 = amiable) were collected before intranasal drugs and at pre-induction. Anxiety score \>2 was considered to be better for the patient.
Time frame: 1 day
Anxiety Score of Patients Receiving Intranasal Placebo or Dexmedetomidine
4-point anxiety score: 1. = combative 2. = anxious 3. = calm 4. = amiable. Anxiety score \>2 was considered to be better for the preoperative patients.
Time frame: 1 day
Systolic Blood Pressure（SBP）of Patients Receiving Intranasal Placebo or Dexmedetomidine
Systolic blood pressure（SBP）of Patients Receiving Intranasal Placebo or Dexmedetomidine.
Time frame: 1 day
Number of Participants With Satisfaction Score <2
Patient satisfaction scores using a 3-point satisfaction score (1 = highly satisfactory, 2 = acceptable, and 3 = unacceptable) were collected when patients were discharged from the post-anesthesia care unit (PACU). Satisfaction score \<2 was considered to be better for the patient
Time frame: 1 day
Perioperative Bradycardia Episodes
Bradycardia was defined as heart rate (HR) \<45 bpm for more than 10 s.
Time frame: 1 day
Perioperative Tachycardia Episodes
Tachycardia was defined as heart rate (HR) \>100 bpm for more than 10 s.
Time frame: 1 day
Perioperative Hypotension Episodes
Hypotension was defined as systolic blood pressure (SBP) decreased more than 30% of the pre-operative value for more than 1 min.
Time frame: 1 day
Perioperative Hypertonsion Episodes
Hypertension was defined as systolic blood pressure (SBP) increased 130% of the pre-operative value for more than 1 min.
Time frame: 1 day
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