open access

Vol 49, No 4 (2017)
Original and clinical articles
Published online: 2017-10-05
Submitted: 2017-03-31
Accepted: 2017-06-20
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Comparison of dexmedetomidine and fentanyl to prevent haemodynamic response to skull pin application in neurosurgery: double blind randomized controlled trial

Cattleya Thongrong, Pannawat Sirikannarat, Pornthep Kasemsiri, Pichayen Duangthongphon
DOI: 10.5603/AIT.a2017.0051
·
Pubmed: 29027653
·
Anaesthesiol Intensive Ther 2017;49(4):268-273.

open access

Vol 49, No 4 (2017)
Original and clinical articles
Published online: 2017-10-05
Submitted: 2017-03-31
Accepted: 2017-06-20

Abstract

BACKGROUND: Skull pin application during craniotomy is a highly noxious stimulus. Therefore, the attenuated effect between dexmedetomidine and fentanyl was investigated.

METHOD: A randomized, double-blind controlled trial included sixty patients, randomly allocated into groups A and B. After patients entered the operative room, blood pressure and heart rate were measured (T1). At 5 minutes after propofol induction (T2), group A received dexmedetomidine 1 µg kg-1 whereas group B received normal saline. At 3 minutes before skull pin insertion (T3), group B received a single bolus of fentanyl 1 µg kg-1 whereas group A received normal saline. The hemodynamic responses were recorded at 1 minute before skull pin insertion (T4), during skull pin insertion (T5), then repeated every minute for 5 minutes (T6-T10).

RESULTS: Controlling blood pressure in the dexmedetomidine group (Group A) was better than in the fentanyl group (Group B) at T4 and T10 (P < 0.05) and T5-T8 (P < 0.01) for systolic blood pressure whereas diastolic blood pressure was significantly different at T4 and T8 (P < 0.05) and T5-T7 (P < 0.01). Mean arterial pressure, also was better controlled in group A at T4 and T10 (P < 0.05) and T5-T8 (P < 0.01). The heart rate in group A was lower than group B at T9 (P < 0.05) and T3-T6 (P < 0.01). Regarding adverse events, 11 hypertensive and 2 hypotensive responses occurred in group B whereas group A just only had 7 incidences of hypotension.

CONCLUSION: The attenuated effect of dexmedetomidine infusion is significantly greater than fentanyl infusion.

Abstract

BACKGROUND: Skull pin application during craniotomy is a highly noxious stimulus. Therefore, the attenuated effect between dexmedetomidine and fentanyl was investigated.

METHOD: A randomized, double-blind controlled trial included sixty patients, randomly allocated into groups A and B. After patients entered the operative room, blood pressure and heart rate were measured (T1). At 5 minutes after propofol induction (T2), group A received dexmedetomidine 1 µg kg-1 whereas group B received normal saline. At 3 minutes before skull pin insertion (T3), group B received a single bolus of fentanyl 1 µg kg-1 whereas group A received normal saline. The hemodynamic responses were recorded at 1 minute before skull pin insertion (T4), during skull pin insertion (T5), then repeated every minute for 5 minutes (T6-T10).

RESULTS: Controlling blood pressure in the dexmedetomidine group (Group A) was better than in the fentanyl group (Group B) at T4 and T10 (P < 0.05) and T5-T8 (P < 0.01) for systolic blood pressure whereas diastolic blood pressure was significantly different at T4 and T8 (P < 0.05) and T5-T7 (P < 0.01). Mean arterial pressure, also was better controlled in group A at T4 and T10 (P < 0.05) and T5-T8 (P < 0.01). The heart rate in group A was lower than group B at T9 (P < 0.05) and T3-T6 (P < 0.01). Regarding adverse events, 11 hypertensive and 2 hypotensive responses occurred in group B whereas group A just only had 7 incidences of hypotension.

CONCLUSION: The attenuated effect of dexmedetomidine infusion is significantly greater than fentanyl infusion.

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Keywords

skull pin application, haemodynamic response; alpha-2 receptor, agonists, dexmedetomidine; opioids, fentanyl

About this article
Title

Comparison of dexmedetomidine and fentanyl to prevent haemodynamic response to skull pin application in neurosurgery: double blind randomized controlled trial

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 4 (2017)

Pages

268-273

Published online

2017-10-05

DOI

10.5603/AIT.a2017.0051

Pubmed

29027653

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(4):268-273.

Keywords

skull pin application
haemodynamic response
alpha-2 receptor
agonists
dexmedetomidine
opioids
fentanyl

Authors

Cattleya Thongrong
Pannawat Sirikannarat
Pornthep Kasemsiri
Pichayen Duangthongphon

References (16)
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