CONSORT the effect of intraoperative dexmedetomidine on hemodynamic responses during emergence from nasotracheal intubation after oral surgery

Abstract

Background: Dexmedetomidine provides smooth emergence with reduced agitation. The authors hypothesized low-dose dexmedetomidine infusion might contribute to hemodynamic stability during and after nasotracheal tube extubation. Methods: Ninety-three adult patients scheduled for oral and maxillofacial surgery were enrolled in this prospective study. Patients were randomly assigned to receive normal saline (control group, n= 31), dexmedetomidine at 0.2 mu g/kg/h (DEX0.2 group, n= 31), or dexmedetomidine at 0.4 mu g/kg/h (DEX0.4 group, n= 31). Mean arterial pressure (MAP), heart rate (HR), and response entropy (RE) and state entropy (SE) were recorded during emergence from anesthesia. Results: Extubation times were similar in the 3 groups. Mean MAP was significantly lower at eye opening (T3) and immediately after extubation (T4) in the DEX0.2 (P=. 013 and.003, respectively) and DEX0.4 group (P=. 003 and.027, respectively) than in the control group. At T3 and T4, mean HR was significantly higher in the control group than in the DEX0.2 (P=. 014 and.022, respectively) or DEX0.4 groups (P=. 003 and <. 001, respectively). In the postanesthetic care unit, mean MAP and HR were significantly lower in the DEX0.2 (P=. 03 and.022, respectively) and DEX0.4 groups (P=. 027 and <. 001, respectively) than in the control group. Conclusion: Intraoperative dexmedetomidine infusion at rates of 0.2 or 0.4 mu g/kg/h during oral and maxillofacial surgery could provide stable hemodynamic profiles during anesthetic emergence from nasotracheal intubation without delaying extubation times.