Preoperative dexmedetomidine attenuates hemodynamic responses to hydrodissection in patients undergoing robotic thyroidectomy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Percutaneous tunneling (hydrodissection) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate. We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration (EC50) of remifentanil needed to maintain hemodynamic stability during hydrodissection. Methods: Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups—group D (n = 22) and group C (n = 19) patients received dexmedetomidine 1 µg/kg and normal saline for 10 min before anesthetic induction, respectively. The EC50 of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon’s up-and-down method with initial dose (4 and 5 ng/mL in groups D and C, respectively). The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient, using increments or decrements of 0.5 ng/mL. Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure <20 % of baseline. Results: The EC50 of remifentanil for maintaining hemodynamic stability during hydrodissection was 0.8 ng/mL in group D and 7.3 ng/mL in group C (p = 0.002). Conclusions: A single preoperative dexmedetomidine injection attenuated hydrodissection-induced hemodynamic responses in patients undergoing robotic thyroidectomy.

Original languageEnglish
Pages (from-to)191-197
Number of pages7
JournalJournal of Anesthesia
Volume29
Issue number2
DOIs
StatePublished - 1 Apr 2015

Fingerprint

Dexmedetomidine
Thyroidectomy
Robotics
Hemodynamics
Blood Pressure
Dilatation and Curettage
Injections
Anesthetics
Neck
Thorax
Heart Rate
remifentanil

Keywords

  • Dexmedetomidine
  • Hemodynamic response
  • Hydrodissection
  • Remifentanil
  • Robot-assisted thyroidectomy

Cite this

@article{18101c7701c549649d54bf3058167103,
title = "Preoperative dexmedetomidine attenuates hemodynamic responses to hydrodissection in patients undergoing robotic thyroidectomy",
abstract = "Purpose: Percutaneous tunneling (hydrodissection) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate. We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration (EC50) of remifentanil needed to maintain hemodynamic stability during hydrodissection. Methods: Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups—group D (n = 22) and group C (n = 19) patients received dexmedetomidine 1 µg/kg and normal saline for 10 min before anesthetic induction, respectively. The EC50 of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon’s up-and-down method with initial dose (4 and 5 ng/mL in groups D and C, respectively). The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient, using increments or decrements of 0.5 ng/mL. Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure <20 {\%} of baseline. Results: The EC50 of remifentanil for maintaining hemodynamic stability during hydrodissection was 0.8 ng/mL in group D and 7.3 ng/mL in group C (p = 0.002). Conclusions: A single preoperative dexmedetomidine injection attenuated hydrodissection-induced hemodynamic responses in patients undergoing robotic thyroidectomy.",
keywords = "Dexmedetomidine, Hemodynamic response, Hydrodissection, Remifentanil, Robot-assisted thyroidectomy",
author = "Kang, {Mae Hwa} and Lee, {Ho Jin} and Lim, {Young Jin} and Jeon, {Young Tae} and Jung-Won Hwang and Park, {Hee Pyoung}",
year = "2015",
month = "4",
day = "1",
doi = "10.1007/s00540-014-1923-6",
language = "English",
volume = "29",
pages = "191--197",
journal = "Journal of Anesthesia",
issn = "0913-8668",
publisher = "Springer Japan",
number = "2",

}

TY - JOUR

T1 - Preoperative dexmedetomidine attenuates hemodynamic responses to hydrodissection in patients undergoing robotic thyroidectomy

AU - Kang, Mae Hwa

AU - Lee, Ho Jin

AU - Lim, Young Jin

AU - Jeon, Young Tae

AU - Hwang, Jung-Won

AU - Park, Hee Pyoung

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Purpose: Percutaneous tunneling (hydrodissection) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate. We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration (EC50) of remifentanil needed to maintain hemodynamic stability during hydrodissection. Methods: Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups—group D (n = 22) and group C (n = 19) patients received dexmedetomidine 1 µg/kg and normal saline for 10 min before anesthetic induction, respectively. The EC50 of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon’s up-and-down method with initial dose (4 and 5 ng/mL in groups D and C, respectively). The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient, using increments or decrements of 0.5 ng/mL. Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure <20 % of baseline. Results: The EC50 of remifentanil for maintaining hemodynamic stability during hydrodissection was 0.8 ng/mL in group D and 7.3 ng/mL in group C (p = 0.002). Conclusions: A single preoperative dexmedetomidine injection attenuated hydrodissection-induced hemodynamic responses in patients undergoing robotic thyroidectomy.

AB - Purpose: Percutaneous tunneling (hydrodissection) in the neck and anterior chest in patients undergoing robotic thyroidectomy leads to significant hemodynamic responses such as increases in blood pressure and heart rate. We evaluated whether a single preoperative dexmedetomidine injection attenuated hemodynamic responses to hydrodissection by reducing the half-maximal effective concentration (EC50) of remifentanil needed to maintain hemodynamic stability during hydrodissection. Methods: Forty-one patients undergoing robot-assisted endoscopic thyroidectomy were randomly allocated to one of the two groups—group D (n = 22) and group C (n = 19) patients received dexmedetomidine 1 µg/kg and normal saline for 10 min before anesthetic induction, respectively. The EC50 of remifentanil for hemodynamic stability during hydrodissection was determined using Dixon’s up-and-down method with initial dose (4 and 5 ng/mL in groups D and C, respectively). The concentration of remifentanil for consecutive patients in each group was determined by the response of the previous patient, using increments or decrements of 0.5 ng/mL. Hemodynamic stability during hydrodissection was defined as increased systolic blood pressure <20 % of baseline. Results: The EC50 of remifentanil for maintaining hemodynamic stability during hydrodissection was 0.8 ng/mL in group D and 7.3 ng/mL in group C (p = 0.002). Conclusions: A single preoperative dexmedetomidine injection attenuated hydrodissection-induced hemodynamic responses in patients undergoing robotic thyroidectomy.

KW - Dexmedetomidine

KW - Hemodynamic response

KW - Hydrodissection

KW - Remifentanil

KW - Robot-assisted thyroidectomy

UR - http://www.scopus.com/inward/record.url?scp=84930731256&partnerID=8YFLogxK

U2 - 10.1007/s00540-014-1923-6

DO - 10.1007/s00540-014-1923-6

M3 - Article

C2 - 25262475

AN - SCOPUS:84930731256

VL - 29

SP - 191

EP - 197

JO - Journal of Anesthesia

JF - Journal of Anesthesia

SN - 0913-8668

IS - 2

ER -