Intraoperative use of low-dose dexmedetomidine for the prevention of emergence agitation following general anaesthesia in elderly patients: a randomized controlled trial
Objective To clarify the effect of an intraoperative low-dose dexmedetomidine infusion on emergence agitation following general anaesthesia in elderly patients. Methods Eighty elderly patients (> 64-years-old) following elective general anaesthesia for radical cancer surgeries were randomly alloc...
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| Veröffentlicht in: | Aging clinical and experimental research 2022-03, Vol.34 (3), p.611-618 |
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| container_title | Aging clinical and experimental research |
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| creator | Sun, Meiyan Peng, Tianliang Sun, Yingui Huang, Zhaolu Jiang, Jun Wang, Chunling Li, Yanjing Zhang, Yue Kong, Wenwen Fan, Lulu Sun, Xude Zhao, Xiaoyong |
| description | Objective
To clarify the effect of an intraoperative low-dose dexmedetomidine infusion on emergence agitation following general anaesthesia in elderly patients.
Methods
Eighty elderly patients (> 64-years-old) following elective general anaesthesia for radical cancer surgeries were randomly allocated into two groups (
n
= 40 each): the dexmedetomidine group (Group D) and the normal saline group (Group C). Anaesthesia was maintained with continuous intravenous infusion of dexmedetomidine at − 0.2 µg kg
−1
h
−1
in Group D, and an equal volume of normal saline (0.5 ml kg
−1
h
−1
) was given in Group C. All patients were observed for 30 min in the post-anaesthesia care unit (PACU), AFPS and NRS were recorded every 2 min, and the total doses of nalbuphine and fentanyl were calculated in the PACU. MAP and HR were recorded at the time of 10 min (T1), 20 min (T2), 30 min (T3) after dexmedetomidine or saline pumping, and before extubation (T4), immediately after extubation (T5), and 5 min after extubation (T6). We also documented some durations, including anaesthesia duration (D1), surgery duration (D2), duration from the end of surgery to extubation (D3), and emergence agitation duration (D4).
Results
The MAP in Group C was significantly higher than that in Group D (
P
|
| doi_str_mv | 10.1007/s40520-021-01984-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2575371457</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2575371457</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-21c9c659c2a10f9b0ca7498441fefb77e4c82afefe810ba5b661fe78916e60b63</originalsourceid><addsrcrecordid>eNp9kc1u1TAQhS0EoqXwAiyQJTZsAnYcxwk7VNFSqRIbWFsTZ3Jx5djBTloub8RbMu0tP2LByuOZb86M5jD2XIrXUgjzpjRC16IStayE7Lum2j9gx9JQqlOyf_hXfMSelHIlRCPp85gdqUZroVt1zH5cxDVDWjDD6q-RbwV5mnhIN9WYKB7x24wjrmn2o4_Ip5T5-gX5kvEa4-pTvMVxxrzD6JDDzq9wl55SIBUfd5wqJB84RMBCzcUD95FjGDGHPV-IJ6nylgPPEEca9R1H7hJtRhoUrtlDeMoeTRAKPrt_T9jns_efTj9Ulx_PL07fXVZOGb1WtXS9a3XvapBi6gfhwDR0nEZOOA3GYOO6GijGTooB9NC2VDFdL1tsxdCqE_bqoLvk9HWjhe3si8MQIGLaiq210crIRhtCX_6DXqUtR9rO1q3SSnV0cqLqA-VyKiXjZJfsZ8h7K4W9NdIejLRkpL0z0u6p6cW99DaQAb9bfjlHgDoAhUpxh_nP7P_I_gTSo64L</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2635338004</pqid></control><display><type>article</type><title>Intraoperative use of low-dose dexmedetomidine for the prevention of emergence agitation following general anaesthesia in elderly patients: a randomized controlled trial</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Sun, Meiyan ; Peng, Tianliang ; Sun, Yingui ; Huang, Zhaolu ; Jiang, Jun ; Wang, Chunling ; Li, Yanjing ; Zhang, Yue ; Kong, Wenwen ; Fan, Lulu ; Sun, Xude ; Zhao, Xiaoyong</creator><creatorcontrib>Sun, Meiyan ; Peng, Tianliang ; Sun, Yingui ; Huang, Zhaolu ; Jiang, Jun ; Wang, Chunling ; Li, Yanjing ; Zhang, Yue ; Kong, Wenwen ; Fan, Lulu ; Sun, Xude ; Zhao, Xiaoyong</creatorcontrib><description>Objective
To clarify the effect of an intraoperative low-dose dexmedetomidine infusion on emergence agitation following general anaesthesia in elderly patients.
Methods
Eighty elderly patients (> 64-years-old) following elective general anaesthesia for radical cancer surgeries were randomly allocated into two groups (
n
= 40 each): the dexmedetomidine group (Group D) and the normal saline group (Group C). Anaesthesia was maintained with continuous intravenous infusion of dexmedetomidine at − 0.2 µg kg
−1
h
−1
in Group D, and an equal volume of normal saline (0.5 ml kg
−1
h
−1
) was given in Group C. All patients were observed for 30 min in the post-anaesthesia care unit (PACU), AFPS and NRS were recorded every 2 min, and the total doses of nalbuphine and fentanyl were calculated in the PACU. MAP and HR were recorded at the time of 10 min (T1), 20 min (T2), 30 min (T3) after dexmedetomidine or saline pumping, and before extubation (T4), immediately after extubation (T5), and 5 min after extubation (T6). We also documented some durations, including anaesthesia duration (D1), surgery duration (D2), duration from the end of surgery to extubation (D3), and emergence agitation duration (D4).
Results
The MAP in Group C was significantly higher than that in Group D (
P
< 0.05), and there were no significant changes between the two groups in HR and MAP within each time point and D1, D2, D3, and D4. The incidence of agitation, NRS score and total dose of nalbuphine and fentanyl were all lower in Group D than in Group C (
P
< 0.05).
Conclusion
An intraoperative low-dose dexmedetomidine continuous infusion can reduce emergence agitation following general anaesthesia in elderly patients (> 64-years-old), remain stable in terms of haemodynamics, and not lead to delays in anaesthesia recovery time and extubation time.</description><identifier>ISSN: 1720-8319</identifier><identifier>ISSN: 1594-0667</identifier><identifier>EISSN: 1720-8319</identifier><identifier>DOI: 10.1007/s40520-021-01984-y</identifier><identifier>PMID: 34550563</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Anesthesia Recovery Period ; Anesthesia, General - adverse effects ; Cancer surgery ; Clinical trials ; Dexmedetomidine ; Double-Blind Method ; Emergence Delirium - prevention & control ; Extubation ; Fentanyl ; Fentanyl - adverse effects ; General anesthesia ; Geriatrics/Gerontology ; Humans ; Hypnotics and Sedatives - adverse effects ; Medicine ; Medicine & Public Health ; Older people ; Original Article</subject><ispartof>Aging clinical and experimental research, 2022-03, Vol.34 (3), p.611-618</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.</rights><rights>The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-21c9c659c2a10f9b0ca7498441fefb77e4c82afefe810ba5b661fe78916e60b63</citedby><cites>FETCH-LOGICAL-c375t-21c9c659c2a10f9b0ca7498441fefb77e4c82afefe810ba5b661fe78916e60b63</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/s40520-021-01984-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40520-021-01984-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34550563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sun, Meiyan</creatorcontrib><creatorcontrib>Peng, Tianliang</creatorcontrib><creatorcontrib>Sun, Yingui</creatorcontrib><creatorcontrib>Huang, Zhaolu</creatorcontrib><creatorcontrib>Jiang, Jun</creatorcontrib><creatorcontrib>Wang, Chunling</creatorcontrib><creatorcontrib>Li, Yanjing</creatorcontrib><creatorcontrib>Zhang, Yue</creatorcontrib><creatorcontrib>Kong, Wenwen</creatorcontrib><creatorcontrib>Fan, Lulu</creatorcontrib><creatorcontrib>Sun, Xude</creatorcontrib><creatorcontrib>Zhao, Xiaoyong</creatorcontrib><title>Intraoperative use of low-dose dexmedetomidine for the prevention of emergence agitation following general anaesthesia in elderly patients: a randomized controlled trial</title><title>Aging clinical and experimental research</title><addtitle>Aging Clin Exp Res</addtitle><addtitle>Aging Clin Exp Res</addtitle><description>Objective
To clarify the effect of an intraoperative low-dose dexmedetomidine infusion on emergence agitation following general anaesthesia in elderly patients.
Methods
Eighty elderly patients (> 64-years-old) following elective general anaesthesia for radical cancer surgeries were randomly allocated into two groups (
n
= 40 each): the dexmedetomidine group (Group D) and the normal saline group (Group C). Anaesthesia was maintained with continuous intravenous infusion of dexmedetomidine at − 0.2 µg kg
−1
h
−1
in Group D, and an equal volume of normal saline (0.5 ml kg
−1
h
−1
) was given in Group C. All patients were observed for 30 min in the post-anaesthesia care unit (PACU), AFPS and NRS were recorded every 2 min, and the total doses of nalbuphine and fentanyl were calculated in the PACU. MAP and HR were recorded at the time of 10 min (T1), 20 min (T2), 30 min (T3) after dexmedetomidine or saline pumping, and before extubation (T4), immediately after extubation (T5), and 5 min after extubation (T6). We also documented some durations, including anaesthesia duration (D1), surgery duration (D2), duration from the end of surgery to extubation (D3), and emergence agitation duration (D4).
Results
The MAP in Group C was significantly higher than that in Group D (
P
< 0.05), and there were no significant changes between the two groups in HR and MAP within each time point and D1, D2, D3, and D4. The incidence of agitation, NRS score and total dose of nalbuphine and fentanyl were all lower in Group D than in Group C (
P
< 0.05).
Conclusion
An intraoperative low-dose dexmedetomidine continuous infusion can reduce emergence agitation following general anaesthesia in elderly patients (> 64-years-old), remain stable in terms of haemodynamics, and not lead to delays in anaesthesia recovery time and extubation time.</description><subject>Aged</subject><subject>Anesthesia Recovery Period</subject><subject>Anesthesia, General - adverse effects</subject><subject>Cancer surgery</subject><subject>Clinical trials</subject><subject>Dexmedetomidine</subject><subject>Double-Blind Method</subject><subject>Emergence Delirium - prevention & control</subject><subject>Extubation</subject><subject>Fentanyl</subject><subject>Fentanyl - adverse effects</subject><subject>General anesthesia</subject><subject>Geriatrics/Gerontology</subject><subject>Humans</subject><subject>Hypnotics and Sedatives - adverse effects</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Older people</subject><subject>Original Article</subject><issn>1720-8319</issn><issn>1594-0667</issn><issn>1720-8319</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1u1TAQhS0EoqXwAiyQJTZsAnYcxwk7VNFSqRIbWFsTZ3Jx5djBTloub8RbMu0tP2LByuOZb86M5jD2XIrXUgjzpjRC16IStayE7Lum2j9gx9JQqlOyf_hXfMSelHIlRCPp85gdqUZroVt1zH5cxDVDWjDD6q-RbwV5mnhIN9WYKB7x24wjrmn2o4_Ip5T5-gX5kvEa4-pTvMVxxrzD6JDDzq9wl55SIBUfd5wqJB84RMBCzcUD95FjGDGHPV-IJ6nylgPPEEca9R1H7hJtRhoUrtlDeMoeTRAKPrt_T9jns_efTj9Ulx_PL07fXVZOGb1WtXS9a3XvapBi6gfhwDR0nEZOOA3GYOO6GijGTooB9NC2VDFdL1tsxdCqE_bqoLvk9HWjhe3si8MQIGLaiq210crIRhtCX_6DXqUtR9rO1q3SSnV0cqLqA-VyKiXjZJfsZ8h7K4W9NdIejLRkpL0z0u6p6cW99DaQAb9bfjlHgDoAhUpxh_nP7P_I_gTSo64L</recordid><startdate>20220301</startdate><enddate>20220301</enddate><creator>Sun, Meiyan</creator><creator>Peng, Tianliang</creator><creator>Sun, Yingui</creator><creator>Huang, Zhaolu</creator><creator>Jiang, Jun</creator><creator>Wang, Chunling</creator><creator>Li, Yanjing</creator><creator>Zhang, Yue</creator><creator>Kong, Wenwen</creator><creator>Fan, Lulu</creator><creator>Sun, Xude</creator><creator>Zhao, Xiaoyong</creator><general>Springer International Publishing</general><general>Springer Nature B.V</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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20220301</creationdate><title>Intraoperative use of low-dose dexmedetomidine for the prevention of emergence agitation following general anaesthesia in elderly patients: a randomized controlled trial</title><author>Sun, Meiyan ; Peng, Tianliang ; Sun, Yingui ; Huang, Zhaolu ; Jiang, Jun ; Wang, Chunling ; Li, Yanjing ; Zhang, Yue ; Kong, Wenwen ; Fan, Lulu ; Sun, Xude ; Zhao, Xiaoyong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-21c9c659c2a10f9b0ca7498441fefb77e4c82afefe810ba5b661fe78916e60b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Anesthesia Recovery Period</topic><topic>Anesthesia, General - adverse effects</topic><topic>Cancer surgery</topic><topic>Clinical trials</topic><topic>Dexmedetomidine</topic><topic>Double-Blind Method</topic><topic>Emergence Delirium - prevention & control</topic><topic>Extubation</topic><topic>Fentanyl</topic><topic>Fentanyl - adverse effects</topic><topic>General anesthesia</topic><topic>Geriatrics/Gerontology</topic><topic>Humans</topic><topic>Hypnotics and Sedatives - adverse effects</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Older people</topic><topic>Original Article</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sun, Meiyan</creatorcontrib><creatorcontrib>Peng, Tianliang</creatorcontrib><creatorcontrib>Sun, Yingui</creatorcontrib><creatorcontrib>Huang, Zhaolu</creatorcontrib><creatorcontrib>Jiang, Jun</creatorcontrib><creatorcontrib>Wang, Chunling</creatorcontrib><creatorcontrib>Li, Yanjing</creatorcontrib><creatorcontrib>Zhang, Yue</creatorcontrib><creatorcontrib>Kong, Wenwen</creatorcontrib><creatorcontrib>Fan, Lulu</creatorcontrib><creatorcontrib>Sun, Xude</creatorcontrib><creatorcontrib>Zhao, Xiaoyong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Aging clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sun, Meiyan</au><au>Peng, Tianliang</au><au>Sun, Yingui</au><au>Huang, Zhaolu</au><au>Jiang, Jun</au><au>Wang, Chunling</au><au>Li, Yanjing</au><au>Zhang, Yue</au><au>Kong, Wenwen</au><au>Fan, Lulu</au><au>Sun, Xude</au><au>Zhao, Xiaoyong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intraoperative use of low-dose dexmedetomidine for the prevention of emergence agitation following general anaesthesia in elderly patients: a randomized controlled trial</atitle><jtitle>Aging clinical and experimental research</jtitle><stitle>Aging Clin Exp Res</stitle><addtitle>Aging Clin Exp Res</addtitle><date>2022-03-01</date><risdate>2022</risdate><volume>34</volume><issue>3</issue><spage>611</spage><epage>618</epage><pages>611-618</pages><issn>1720-8319</issn><issn>1594-0667</issn><eissn>1720-8319</eissn><abstract>Objective
To clarify the effect of an intraoperative low-dose dexmedetomidine infusion on emergence agitation following general anaesthesia in elderly patients.
Methods
Eighty elderly patients (> 64-years-old) following elective general anaesthesia for radical cancer surgeries were randomly allocated into two groups (
n
= 40 each): the dexmedetomidine group (Group D) and the normal saline group (Group C). Anaesthesia was maintained with continuous intravenous infusion of dexmedetomidine at − 0.2 µg kg
−1
h
−1
in Group D, and an equal volume of normal saline (0.5 ml kg
−1
h
−1
) was given in Group C. All patients were observed for 30 min in the post-anaesthesia care unit (PACU), AFPS and NRS were recorded every 2 min, and the total doses of nalbuphine and fentanyl were calculated in the PACU. MAP and HR were recorded at the time of 10 min (T1), 20 min (T2), 30 min (T3) after dexmedetomidine or saline pumping, and before extubation (T4), immediately after extubation (T5), and 5 min after extubation (T6). We also documented some durations, including anaesthesia duration (D1), surgery duration (D2), duration from the end of surgery to extubation (D3), and emergence agitation duration (D4).
Results
The MAP in Group C was significantly higher than that in Group D (
P
< 0.05), and there were no significant changes between the two groups in HR and MAP within each time point and D1, D2, D3, and D4. The incidence of agitation, NRS score and total dose of nalbuphine and fentanyl were all lower in Group D than in Group C (
P
< 0.05).
Conclusion
An intraoperative low-dose dexmedetomidine continuous infusion can reduce emergence agitation following general anaesthesia in elderly patients (> 64-years-old), remain stable in terms of haemodynamics, and not lead to delays in anaesthesia recovery time and extubation time.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34550563</pmid><doi>10.1007/s40520-021-01984-y</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1720-8319 |
| ispartof | Aging clinical and experimental research, 2022-03, Vol.34 (3), p.611-618 |
| issn | 1720-8319 1594-0667 1720-8319 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Aged Anesthesia Recovery Period Anesthesia, General - adverse effects Cancer surgery Clinical trials Dexmedetomidine Double-Blind Method Emergence Delirium - prevention & control Extubation Fentanyl Fentanyl - adverse effects General anesthesia Geriatrics/Gerontology Humans Hypnotics and Sedatives - adverse effects Medicine Medicine & Public Health Older people Original Article |
| title | Intraoperative use of low-dose dexmedetomidine for the prevention of emergence agitation following general anaesthesia in elderly patients: a randomized controlled trial |
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