Premedication with dexmedetomidine to reduce emergence agitation: a randomized controlled trial
Premedication with dexmedetomidine to reduce emergence agitation: a randomized controlled trial
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DOI：
10.1186/s12871-019-0816-5
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发表时间：
2019-08-07
影响因子：
2.2
通讯作者：
Ahn, So Woon
中科院分区：
文献类型：
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作者：
Kim, Jong Chan;Kim, Jihee;Ahn, So Woon
背景 鼻骨骨折是最常见的面部骨折类型，鼻骨骨折闭合复位后严重苏醒期躁动的发生率很高，处理起来具有挑战性。本试验的目的是评估术前给予右美托咪定是否能有效降低接受鼻骨骨折闭合复位的成人苏醒期躁动的发生率和严重程度。方法 在这项随机对照试验中，前瞻性纳入了 90 名计划接受鼻骨骨折闭合复位术的患者，并随机分配到对照组（n = 45；输注 0.9% 生理盐水）或右美托咪定组（n = 45；术前 1 mu/kg，持续 10 分钟）。主要终点是麻醉后 Aono 的四分制评分。恢复时间和数字评定量表分数被评估为次要终点。结果 右美托咪定组 Aono 四点量表评分低于对照组（中位数：1 [1] 比 1 [1, 2]，95% 差异置信区间：0.01 至 0.02，P = 0.02）。右美托咪定组躁动发作的次数、严重程度和持续时间显着低于对照组。此外，右美托咪定组中出现术中活动的患者数量较少。结论 术前给予右美托咪定具有多项显着益处，例如较低的苏醒期躁动发生率、减轻的躁动严重程度以及较短的躁动持续时间。此外，我们观察到术中麻醉维持更稳定，手术期间运动更少。
Background Nasal bone fracture is the most common type of facial fracture, and the high incidence of severe emergence agitation occurring after closed reduction of the nasal bone fracture can be challenging to manage. The purpose of this trial was to evaluate whether pre-operative administration of dexmedetomidine is effective in reducing the incidence and severity of emergence agitation in adults undergoing closed reduction of nasal bone fractures. Methods In this randomized controlled trial, 90 patients who were scheduled to undergo closed reduction of a nasal bone fracture were prospectively included and were randomly assigned to either the control group (n = 45; 0.9% saline infusion) or the dexmedetomidine group (n = 45; 1 mu/kg over 10 min, pre-operatively). The primary endpoint was Aono's four-point scale scores after anesthesia. The recovery time and numeric rating scale score were assessed as secondary endpoints. Results Aono's four-point scale scores were lower in the dexmedetomidine group than in the control group (median: 1 [1] vs. 1 [1, 2], 95% confidence interval of difference: 0.01 to 0.02, P = 0.02). The number, severity, and duration of agitation episodes were significantly lower in the dexmedetomidine group than in the control group. Furthermore, the number of patients exhibiting intraoperative movement was lower in the dexmedetomidine group. Conclusions Pre-operative administration of dexmedetomidine demonstrated several significant benefits, such as a lower incidence of emergence agitation, reduced agitation severity, and a shorter duration of agitation. Additionally, we observed more stable maintenance of intraoperative anesthesia with less movement during the surgery.