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Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients?
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 t...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279802/ https://www.ncbi.nlm.nih.gov/pubmed/25550680 http://dx.doi.org/10.1186/1471-2253-14-113 |
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author | Sezen, Gulbin Demiraran, Yavuz Seker, Ilknur Suidiye Karagoz, Ibrahim Iskender, Abdulkadir Ankarali, Handan Ersoy, Ozlem Ozlu, Onur |
author_facet | Sezen, Gulbin Demiraran, Yavuz Seker, Ilknur Suidiye Karagoz, Ibrahim Iskender, Abdulkadir Ankarali, Handan Ersoy, Ozlem Ozlu, Onur |
author_sort | Sezen, Gulbin |
collection | PubMed |
description | 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(intubation)(5 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. |
format | Online Article Text |
id | pubmed-4279802 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-42798022014-12-31 Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients? Sezen, Gulbin Demiraran, Yavuz Seker, Ilknur Suidiye Karagoz, Ibrahim Iskender, Abdulkadir Ankarali, Handan Ersoy, Ozlem Ozlu, Onur BMC Anesthesiol Research Article 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(intubation)(5 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. BioMed Central 2014-12-10 /pmc/articles/PMC4279802/ /pubmed/25550680 http://dx.doi.org/10.1186/1471-2253-14-113 Text en © Sezen et al.; licensee BioMed Central. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Sezen, Gulbin Demiraran, Yavuz Seker, Ilknur Suidiye Karagoz, Ibrahim Iskender, Abdulkadir Ankarali, Handan Ersoy, Ozlem Ozlu, Onur Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients? |
title | Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients? |
title_full | Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients? |
title_fullStr | Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients? |
title_full_unstemmed | Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients? |
title_short | Does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients? |
title_sort | does premedication with dexmedetomidine provide perioperative hemodynamic stability in hypertensive patients? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279802/ https://www.ncbi.nlm.nih.gov/pubmed/25550680 http://dx.doi.org/10.1186/1471-2253-14-113 |
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