Comparison of Dexmedetomidin and Remifentanil for the Effect on Airway Reflex and Hemodynamic Response During Emergence in Patients Undergoing Craniotomy
Information source: Yonsei University
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Open Craniotomy
Intervention: remifentanil (Drug); dexmedetomidine with remifentanil (Drug)
Phase: Phase 4
Status: Completed
Sponsored by: Yonsei University
Summary
During recovery from general anesthesia the stimuli of endotracheal tube lead to the
coughing, hypertension, tachycardia, which can cause a serious complication. Especially the
postoperative course of patients emerging from general anesthesia after intracranial surgery
is frequently complicated by the occurrence of hypertension and coughing event.
It has been demonstrated that opioid, intravenous or topical lidocaine administration can
attenuate the coughing reflex. Administered the opioid before emergence, it is effective to
prevent cough reflex but the recovery is delayed, it was difficult to predict emergence.
However, remifentanil is an opioid widely used because of rapid context-sensitive half-life,
target-controled infusion method to adequately maintain the effect site concentration could
help to predict the recovery time to the alert state from the general anesthesia. It is
considered proper method of continuous infusion of remifentanil for reducing emergence
cough.
Dexmedetomidine , a potent alpha adrenoceptor agonist which dose-dependently reduces
arterial blood pressure and heart rate, decreases the hemodynamic and and catecholamine
response to intubation and extubation. It is thus theologically appropriate for reducing
airway and circulatory reflexes during emergence from anesthesia.
In this study, the investigators used bolus dexmedetomidine immediately before extubation,
and compared the effects on coughing, hemodynamic response and recovery profile to a
continuous infusion of remifentanil.
Clinical Details
Official title: Comparison of Dexmedetomidin and Remifentanil for the Effect on Airway Reflex and Hemodynamic Response During Emergence in Patients Undergoing Craniotomy
Study design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
Primary outcome: cough incidence
Eligibility
Minimum age: 20 Years.
Maximum age: 70 Years.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- SA I~II, 2. aged between 20 and 70 year, 4. general anesthesia for craniectomy
Exclusion Criteria:
- signs of an anatomical or functional abnormality in upper airway
- URI or sore throat for recent 2 weeks
- Congestive heart failure, Sinus Bradycardia(<50 BPM), Uncontrolled hypertension
- Chronic obstructive lung disease, bronchial asthma
Locations and Contacts
Severance Hospital, Seoul 120-752, Korea, Republic of
Additional Information
Starting date: May 2011
Last updated: June 29, 2014
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