The comparison of intranasal and intravenous dexmedetomidine on the adverse reactions of tracheal extubation during wake up of general anesthesia / 中国医师进修杂志

ABSTRACT

Objective To compare the adverse reactions of intranasal and intravenous dexmedetomidine on tracheal extubation during wake up of general anesthesia.Methods One hundred and twenty patients who ASA Ⅰ or Ⅱ grade were divided into four groups (each 30 patients) by random digits table method.The patients in intravenous group were given 0.5 μ g/kg intravenous dexmedetomidine (diluted to 10 ml by 0.9％ sodium chloride,intravenous injection slowly,≥30 s).The patients in intranasal group 1 were given 0.5 μg/kg intranasal dexmedetomidine.The patients in intranasal group 2 were given 0.8 μg/kg intranasal dexmedetomidine.The patients in control group were given intravenous 0.9％ sodium chloride.The systolic blood pressure(SBP),mean arterial blood pressure (MAP),heart rate were compared among groups.Eyes open time and extubation time,the rate of cough and the degree during extubation were compared too.Results The SBP,MAP,heart rate in intravenous group,intranasal group 1 were significantly higher than those in basal state (P ＜ 0.05).The SBP,MAP,heart rate at different time in intranasal group 2 had no significant difference (P ＞ 0.05).The SBP,MAP,heart rate before extubation and after extubation for 3 min in control group were significantly higher than those in intravenous group,intranasal group 1 and intranasal group 2 (P ＜ 0.05).Eyes open time and extubation time among four groups had no significant difference(P ＞0.05).The rate of cough,restlessness and 3 scores of degree before extubation in intravenous group,intranasal group 1 and intranasal group 2 were significandy lower than those in control group [43％ (13/30),50％(15/30),47％(14/30) vs.70％ (21/30); 17％(5/30),23％(7/30),20％(6/30) vs.43％(13/30);53％ (16/30),60％ (18/30),50％ (15/30) vs.80％ (24/30)] (P ＜ 0.05).Conclusions Either intravenous or intranasal dexmedetomidine can effectively prevent the stress reaction during extubation,decrease the degree of restlessness and cough.Intranasal dexmedetomidine(0.8 μ g/kg) is more effective and safe.