Laryngectomy; Status Clinical Trial
Official title:
A Randomized Controlled Trial of the Effect of Dexmedetomidine Compared With Midazolam on Airway Reflex and Recovery Quality During Emergence From General Anesthesia After Partial and Total Laryngectomy
Background: During emergence from anesthesia for partial and total laryngectomy, severe
airway reflex and systemic hypertension during recovery may lead to pneumoderm, hemorrhage,
pneumomediastinum or pneumothorax. Dexmedetomidine is a selective α2-adrenoreceptor agonist
that has sedative, analgesic, and sympatholytic properties. It has been reported
dexmedetomidine can attenuate coughing reflex and prevent emergence agitation without
delaying recovery and respiratory depression from general anesthesia. The purpose of this
study was to investigate the effect of dexmedetomidine compared with midazolam on cough
suppression and recovery quality during emergence from general anesthesia after partial and
total laryngectomy.
Methods American Society of Anesthesiologists physical status I-II male adults undergoing
elective laryngectomy under sevoflurane anesthesia were recruiting and randomly allocated to
receive either dexmedetomidine(Group D, n = 60) infusion at 0.5 µg•kg−1 for 10 min before
tracheotomy, then adjusted to 0.3µg•kg−1•h−1 or midazolam (Group M, n = 60) infusion at 0.05
mg•kg−1 ten minutes before tracheotomy, then adjusted to 0.02mg•kg−1•h−1. The primary outcome
measure was the incidence and severity of cough. Hemodynamics, pain intensity [Visual
Analogue Scale (VAS)] and Ramsay sedation scale (RSS) were also evaluated at awake, patients
returning to ward from post anesthesia care unit (PACU),2h after surgery. postoperative
sufentanil consumption, recovery time and the incidence of concerning adverse effects were
recorded.
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