The purpose of the present study was to compare the effect of dexmedetomidine which is administered during emergence in adult patients undergoing elective thyroidectomy on smooth emergence form general anesthesia (reducing agitation or coughing, signs of hypertension or tachycardia, or etc.) and postoperative outcome (postoperative bleeding and hospital staying).
Smooth emergence from general anaesthesia after surgery is important to prevent potentially dangerous effects such as hypertension, tachycardia, myocardial ischaemia, arrhythmias and increased intracranial and intra-abdominal pressure. After thyroidectomy, activities during emergence such as agitation or coughing, signs of hypertension or tachycardia, or etc. may lead to postoperative bleeding, resulting in acute airway obstruction or reoperation. The purpose of the present study was to compare the effect of dexmedetomidine which is administered during emergence in adult patients undergoing elective thyroidectomy on smooth emergence form general anesthesia and postoperative outcome.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
139
Anesthesia is maintained with desflurane
Remifentanil is infused for the maintenance of anesthesia during surgery and discontinued 15 min before end of surgery
The aim of this study is evaluation of effect of dexmedetomidine on emergence response and postoperative outcome after thyroidectomy
Chosun University Hospital
Gwangju, Donggu, South Korea
Postoperative bleeding
Postoperative bleeding: Sum of bleeding via barovac
Time frame: From the end of surgery to the 3rd postoperative day (an expected average of 3 days)
Ramsay Sedation scale
Ramsay Sedation scale at recovery room
Time frame: During the recovery time of anesthesia, an expected average of 20 min
Extubation time
time to extubation from the end of surgery
Time frame: During the recovery time of anesthesia, an expected average of 20 min
Recovery time of anesthesia
time to transfer to recovery room from the end of surgery
Time frame: During the recovery time of anesthesia, an expected average of 20 min
Duration of hospital stay
Duration of hospital stay
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 1 week
Pain score
Pain score: NRS
Time frame: From the end of surgery to the 3rd postoperative day (an expected average of 3 days)
Incidence of postoperative complications
Hoarseness, hematoma, and reoperation
Time frame: Participants will be followed for the duration of hospital stay, an expected average of 1 week
Coughing Response
Coughing Response during recovery from anesthesia
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Systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate are measured before infusion of testing drugs, after infusion of them (5 min, 10 min, and 15 min), during extubation (0 min and 5 min after extubation), and at recovery room. And the complications such as hypotension, hypertension, bradycardia, tachycardia, and desaturation after infusion of testing drugs are observed.
During recovery from anesthesia at operation room, cough reflex is measured and rated. \[Grade 0, no cough; Grade 1, single cough with mild severity; Grade 2, cough persistence less than 5 s with moderate severity; Grade 3, severe, persistent cough for more than 5 s (bucking)\]
When the patient has fully awaken and transferred to the recovery room, Ramsay Sedation Scale is measured. 1. Awake Patient anxious and agitated or restless or both! 2. Patient cooperative, oriented and tranquil! 3. Patient responds to commands only! 4. Asleep A brisk response to a light glabellar tap or loud auditory stimulus! 5. A sluggish response to a light glabellar tap or loud auditory stimulus! 6. No response to a light glabellar tap or loud auditory stimulus
The time from discontinuing anesthetic gas to endotracheal extubation is measured. And the time from the discontinuing of anesthetic gas to transferring to the recovery room is also measured.
The severity of pain after surgery is measured by VAS (at recovery room, POD 1, POD 2, and POD 3)
The amount of postoperative bleeding which is collected in the barovac is measured.
Postoperative complications after thyroidectomy such as hoarseness and hematoma, and reoperation due to such complication is observed.
The time from the end of surgery to remove drainage is measured. And the duration of hospital staying is measured.
Dexmedetomidine has started infusion for 15 min (rate of 0.6 ug/kg/hr) before end of surgery as experimental intervention
Normal saline has started infusion for 15 min (as same rate of dexmedetomidine) before end of surgery as control intervention
Time frame: During the recovery time of anesthesia, an expected average of 20 min