Preoperative dexmedetomidine attenuates hemodynamic responses to hydrodissection in patients undergoing robotic thyroidectomy
Purpose Percutaneous tunneling (hydrodissection) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate. We evaluated whether a single preoperative dexmedetomidine injection attenuated...
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| Veröffentlicht in: | Journal of anesthesia 2015-04, Vol.29 (2), p.191-197 |
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| creator | Kang, Mae-Hwa Lee, Ho-Jin Lim, Young-Jin Jeon, Young-Tae Hwang, Jung-Won Park, Hee-Pyoung |
| description | Purpose
Percutaneous tunneling (hydrodissection) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate. We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration (EC50) of remifentanil needed to maintain hemodynamic stability during hydrodissection.
Methods
Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups—group D (
n
= 22) and group C (
n
= 19) patients received dexmedetomidine 1 µg/kg and normal saline for 10 min before anesthetic induction, respectively. The EC50 of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon’s up-and-down method with initial dose (4 and 5 ng/mL in groups D and C, respectively). The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient, using increments or decrements of 0.5 ng/mL. Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure |
| doi_str_mv | 10.1007/s00540-014-1923-6 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1672606286</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A432511300</galeid><sourcerecordid>A432511300</sourcerecordid><originalsourceid>FETCH-LOGICAL-c543t-5cf969c6b417d1a156ed3f84577b615b55fcb63a15974622c09903cd009d8f9a3</originalsourceid><addsrcrecordid>eNp9kU2L1TAYhYMozp3RH-BGCm7cdMxHkzbLYfBjYEAXug5p8rY3Q5vUJBW78L-bS0dBuEgWgfd9ziE5B6FXBF8TjNt3CWPe4BqTpiaSslo8QQfSsK7uGJdP0QFLwupOiO4CXab0gDEWhLDn6IJyKmjT8gP69SVCWCDq7H5AZeHnDBZymJ11HiqdM_hVZ0jVEeZgN69nZ6oIaQk-lWkO1XGzMViXEpjsgq-cr5biBj6navUW4hicH6sY-pCLNh-3GJwtcJi3F-jZoKcELx_vK_Ttw_uvt5_q-88f725v7mvDG5ZrbgYppBF9Q1pLNOECLBu6hrdtLwjvOR9ML1hZyLYRlBosJWbGYixtN0jNrtDb3XeJ4fsKKavZJQPTpD2ENSkiWiqwoJ0o6JsdHfUEyvkh5KjNCVc3DaO8BIhxoeoz1Ai-JDkFD4Mr43_46zN8ORZKoGcFZBeYGFKKMKglulnHTRGsTuWrvXxVylen8tXp6a8ff7n2pca_ij9tF4DuQCorP0JUD2GNviT_H9ffNGi7eg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1672606286</pqid></control><display><type>article</type><title>Preoperative dexmedetomidine attenuates hemodynamic responses to hydrodissection in patients undergoing robotic thyroidectomy</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kang, Mae-Hwa ; Lee, Ho-Jin ; Lim, Young-Jin ; Jeon, Young-Tae ; Hwang, Jung-Won ; Park, Hee-Pyoung</creator><creatorcontrib>Kang, Mae-Hwa ; Lee, Ho-Jin ; Lim, Young-Jin ; Jeon, Young-Tae ; Hwang, Jung-Won ; Park, Hee-Pyoung</creatorcontrib><description>Purpose
Percutaneous tunneling (hydrodissection) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate. We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration (EC50) of remifentanil needed to maintain hemodynamic stability during hydrodissection.
Methods
Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups—group D (
n
= 22) and group C (
n
= 19) patients received dexmedetomidine 1 µg/kg and normal saline for 10 min before anesthetic induction, respectively. The EC50 of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon’s up-and-down method with initial dose (4 and 5 ng/mL in groups D and C, respectively). The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient, using increments or decrements of 0.5 ng/mL. Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure <20 % of baseline.
Results
The EC50 of remifentanil for maintaining hemodynamic stability during hydrodissection was 0.8 ng/mL in group D and 7.3 ng/mL in group C (
p
= 0.002).
Conclusions
A single preoperative dexmedetomidine injection attenuated hydrodissection-induced hemodynamic responses in patients undergoing robotic thyroidectomy.</description><identifier>ISSN: 0913-8668</identifier><identifier>EISSN: 1438-8359</identifier><identifier>DOI: 10.1007/s00540-014-1923-6</identifier><identifier>PMID: 25262475</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Adrenergic alpha-2 Receptor Agonists - therapeutic use ; Adult ; Analgesia ; Anesthesia, Intravenous - adverse effects ; Anesthesia, Intravenous - methods ; Anesthesiology ; Anesthetics, Intravenous ; Critical Care Medicine ; Development and progression ; Dexmedetomidine ; Dexmedetomidine - therapeutic use ; Double-Blind Method ; Emergency Medicine ; Female ; Heart rate ; Hemodynamics - drug effects ; Humans ; Intensive ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Pain Medicine ; Perioperative Care - methods ; Piperidines ; Propofol ; Prospective Studies ; Risk factors ; Robotics ; Thyroidectomy - adverse effects ; Young Adult</subject><ispartof>Journal of anesthesia, 2015-04, Vol.29 (2), p.191-197</ispartof><rights>Japanese Society of Anesthesiologists 2014</rights><rights>COPYRIGHT 2015 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c543t-5cf969c6b417d1a156ed3f84577b615b55fcb63a15974622c09903cd009d8f9a3</citedby><cites>FETCH-LOGICAL-c543t-5cf969c6b417d1a156ed3f84577b615b55fcb63a15974622c09903cd009d8f9a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00540-014-1923-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00540-014-1923-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25262475$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kang, Mae-Hwa</creatorcontrib><creatorcontrib>Lee, Ho-Jin</creatorcontrib><creatorcontrib>Lim, Young-Jin</creatorcontrib><creatorcontrib>Jeon, Young-Tae</creatorcontrib><creatorcontrib>Hwang, Jung-Won</creatorcontrib><creatorcontrib>Park, Hee-Pyoung</creatorcontrib><title>Preoperative dexmedetomidine attenuates hemodynamic responses to hydrodissection in patients undergoing robotic thyroidectomy</title><title>Journal of anesthesia</title><addtitle>J Anesth</addtitle><addtitle>J Anesth</addtitle><description>Purpose
Percutaneous tunneling (hydrodissection) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate. We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration (EC50) of remifentanil needed to maintain hemodynamic stability during hydrodissection.
Methods
Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups—group D (
n
= 22) and group C (
n
= 19) patients received dexmedetomidine 1 µg/kg and normal saline for 10 min before anesthetic induction, respectively. The EC50 of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon’s up-and-down method with initial dose (4 and 5 ng/mL in groups D and C, respectively). The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient, using increments or decrements of 0.5 ng/mL. Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure <20 % of baseline.
Results
The EC50 of remifentanil for maintaining hemodynamic stability during hydrodissection was 0.8 ng/mL in group D and 7.3 ng/mL in group C (
p
= 0.002).
Conclusions
A single preoperative dexmedetomidine injection attenuated hydrodissection-induced hemodynamic responses in patients undergoing robotic thyroidectomy.</description><subject>Adrenergic alpha-2 Receptor Agonists - therapeutic use</subject><subject>Adult</subject><subject>Analgesia</subject><subject>Anesthesia, Intravenous - adverse effects</subject><subject>Anesthesia, Intravenous - methods</subject><subject>Anesthesiology</subject><subject>Anesthetics, Intravenous</subject><subject>Critical Care Medicine</subject><subject>Development and progression</subject><subject>Dexmedetomidine</subject><subject>Dexmedetomidine - therapeutic use</subject><subject>Double-Blind Method</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Heart rate</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Intensive</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Pain Medicine</subject><subject>Perioperative Care - methods</subject><subject>Piperidines</subject><subject>Propofol</subject><subject>Prospective Studies</subject><subject>Risk factors</subject><subject>Robotics</subject><subject>Thyroidectomy - adverse effects</subject><subject>Young Adult</subject><issn>0913-8668</issn><issn>1438-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2L1TAYhYMozp3RH-BGCm7cdMxHkzbLYfBjYEAXug5p8rY3Q5vUJBW78L-bS0dBuEgWgfd9ziE5B6FXBF8TjNt3CWPe4BqTpiaSslo8QQfSsK7uGJdP0QFLwupOiO4CXab0gDEWhLDn6IJyKmjT8gP69SVCWCDq7H5AZeHnDBZymJ11HiqdM_hVZ0jVEeZgN69nZ6oIaQk-lWkO1XGzMViXEpjsgq-cr5biBj6navUW4hicH6sY-pCLNh-3GJwtcJi3F-jZoKcELx_vK_Ttw_uvt5_q-88f725v7mvDG5ZrbgYppBF9Q1pLNOECLBu6hrdtLwjvOR9ML1hZyLYRlBosJWbGYixtN0jNrtDb3XeJ4fsKKavZJQPTpD2ENSkiWiqwoJ0o6JsdHfUEyvkh5KjNCVc3DaO8BIhxoeoz1Ai-JDkFD4Mr43_46zN8ORZKoGcFZBeYGFKKMKglulnHTRGsTuWrvXxVylen8tXp6a8ff7n2pca_ij9tF4DuQCorP0JUD2GNviT_H9ffNGi7eg</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Kang, Mae-Hwa</creator><creator>Lee, Ho-Jin</creator><creator>Lim, Young-Jin</creator><creator>Jeon, Young-Tae</creator><creator>Hwang, Jung-Won</creator><creator>Park, Hee-Pyoung</creator><general>Springer Japan</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150401</creationdate><title>Preoperative dexmedetomidine attenuates hemodynamic responses to hydrodissection in patients undergoing robotic thyroidectomy</title><author>Kang, Mae-Hwa ; Lee, Ho-Jin ; Lim, Young-Jin ; Jeon, Young-Tae ; Hwang, Jung-Won ; Park, Hee-Pyoung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c543t-5cf969c6b417d1a156ed3f84577b615b55fcb63a15974622c09903cd009d8f9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adrenergic alpha-2 Receptor Agonists - therapeutic use</topic><topic>Adult</topic><topic>Analgesia</topic><topic>Anesthesia, Intravenous - adverse effects</topic><topic>Anesthesia, Intravenous - methods</topic><topic>Anesthesiology</topic><topic>Anesthetics, Intravenous</topic><topic>Critical Care Medicine</topic><topic>Development and progression</topic><topic>Dexmedetomidine</topic><topic>Dexmedetomidine - therapeutic use</topic><topic>Double-Blind Method</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Heart rate</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Intensive</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Pain Medicine</topic><topic>Perioperative Care - methods</topic><topic>Piperidines</topic><topic>Propofol</topic><topic>Prospective Studies</topic><topic>Risk factors</topic><topic>Robotics</topic><topic>Thyroidectomy - adverse effects</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kang, Mae-Hwa</creatorcontrib><creatorcontrib>Lee, Ho-Jin</creatorcontrib><creatorcontrib>Lim, Young-Jin</creatorcontrib><creatorcontrib>Jeon, Young-Tae</creatorcontrib><creatorcontrib>Hwang, Jung-Won</creatorcontrib><creatorcontrib>Park, Hee-Pyoung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kang, Mae-Hwa</au><au>Lee, Ho-Jin</au><au>Lim, Young-Jin</au><au>Jeon, Young-Tae</au><au>Hwang, Jung-Won</au><au>Park, Hee-Pyoung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative dexmedetomidine attenuates hemodynamic responses to hydrodissection in patients undergoing robotic thyroidectomy</atitle><jtitle>Journal of anesthesia</jtitle><stitle>J Anesth</stitle><addtitle>J Anesth</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>29</volume><issue>2</issue><spage>191</spage><epage>197</epage><pages>191-197</pages><issn>0913-8668</issn><eissn>1438-8359</eissn><abstract>Purpose
Percutaneous tunneling (hydrodissection) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate. We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration (EC50) of remifentanil needed to maintain hemodynamic stability during hydrodissection.
Methods
Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups—group D (
n
= 22) and group C (
n
= 19) patients received dexmedetomidine 1 µg/kg and normal saline for 10 min before anesthetic induction, respectively. The EC50 of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon’s up-and-down method with initial dose (4 and 5 ng/mL in groups D and C, respectively). The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient, using increments or decrements of 0.5 ng/mL. Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure <20 % of baseline.
Results
The EC50 of remifentanil for maintaining hemodynamic stability during hydrodissection was 0.8 ng/mL in group D and 7.3 ng/mL in group C (
p
= 0.002).
Conclusions
A single preoperative dexmedetomidine injection attenuated hydrodissection-induced hemodynamic responses in patients undergoing robotic thyroidectomy.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>25262475</pmid><doi>10.1007/s00540-014-1923-6</doi><tpages>7</tpages></addata></record> |
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| ispartof | Journal of anesthesia, 2015-04, Vol.29 (2), p.191-197 |
| issn | 0913-8668 1438-8359 |
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| subjects | Adrenergic alpha-2 Receptor Agonists - therapeutic use Adult Analgesia Anesthesia, Intravenous - adverse effects Anesthesia, Intravenous - methods Anesthesiology Anesthetics, Intravenous Critical Care Medicine Development and progression Dexmedetomidine Dexmedetomidine - therapeutic use Double-Blind Method Emergency Medicine Female Heart rate Hemodynamics - drug effects Humans Intensive Male Medicine Medicine & Public Health Middle Aged Original Article Pain Medicine Perioperative Care - methods Piperidines Propofol Prospective Studies Risk factors Robotics Thyroidectomy - adverse effects Young Adult |
| title | Preoperative dexmedetomidine attenuates hemodynamic responses to hydrodissection in patients undergoing robotic thyroidectomy |
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