Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Sezen, Gulbin, Demiraran, Yavuz, Seker, Ilknur Suidiye, Karagoz, Ibrahim, Iskender, Abdulkadir, Ankarali, Handan, Ersoy, Ozlem, Ozlu, Onur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
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
_version_ 1782350764153241600
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
work_keys_str_mv AT sezengulbin doespremedicationwithdexmedetomidineprovideperioperativehemodynamicstabilityinhypertensivepatients
AT demiraranyavuz doespremedicationwithdexmedetomidineprovideperioperativehemodynamicstabilityinhypertensivepatients
AT sekerilknursuidiye doespremedicationwithdexmedetomidineprovideperioperativehemodynamicstabilityinhypertensivepatients
AT karagozibrahim doespremedicationwithdexmedetomidineprovideperioperativehemodynamicstabilityinhypertensivepatients
AT iskenderabdulkadir doespremedicationwithdexmedetomidineprovideperioperativehemodynamicstabilityinhypertensivepatients
AT ankaralihandan doespremedicationwithdexmedetomidineprovideperioperativehemodynamicstabilityinhypertensivepatients
AT ersoyozlem doespremedicationwithdexmedetomidineprovideperioperativehemodynamicstabilityinhypertensivepatients
AT ozluonur doespremedicationwithdexmedetomidineprovideperioperativehemodynamicstabilityinhypertensivepatients