Education and Ethics In Nursing ISSN: 2322-5300

Comparison of the effect of midazolam with intravenous dexmedomidine before extubation on the reactions of getting out of anesthesia in patients after

https://doi.org/10.22034/ethic.2024.2034298.1074
Volume 13, special issue
July 2024
Pages 96-102
Education and Ethics In Nursing ISSN: 2322-5300

Document Type : Original Article

Authors

Reza Sahraei 1
Ali Kazeminezhad 2
Lohrasb Taheri 3
navid kalani 4

1 Associate Professor of Anesthesiology, Department of Anesthesiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran

2 Department of Neurosurgery, Peymanieh Hospital, Trauma Research Center, Jahrom University of Medical Sciences, Jahrom, Iran

3 Assistant Professor of Surgery Department of Surgery, Peymanie Hospital Jahrom University of Medical Sciences ,Jahrom , Iran

4 Phd, Department of Anesthesiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran

Abstract
Introduction: Complications of awakening from general anesthesia may increase the risk of serious complications. Various methods have been studied to suppress the occurrence of these complications. Intraoperative injection of dexmedetomidine can prevent complications of awakening from anesthesia by reducing irritation, cough and hemodynamic changes in children and adults. However, there are conflicting results regarding the effectiveness of dexmedetomidine and midazolam in suppressing cough and other complications during extubation. Therefore, the current study was designed with the aim of "comparing the effect of midazolam with intravenous dexmedetomidine before extubation on the reactions of coming out of anesthesia in patients after lumbar disc surgery".
Methods: This research was a double-blind randomized clinical trial on 90 patients aged 18 to 65 years with anesthesia class 1 and 2,  which included patients undergoing lumbar disc surgery under general anesthesia in Peymaniyeh Hospital, Jahrom (2023). Patients were randomly divided into three groups: A (receiver of midazolam with a dose of 0/2 mg/kg/h) and B (receiver of dexmedetomidine with a dose of 1 μg/kg) and C as a control group (placebo = normal saline). Data analysis was done by descriptive statistics and inferential statistical tests using spss software version 21.
Discussion: This study was done to compare the effect of midazolam with intravenous dexmedomidine before extubation on the reactions of getting out of anesthesia in patients after lumbar disc surgery, in order to prevent the reactions of getting out of anesthesia and minimize its complications in patients undergoing lumbar disc surgery by examining the results of this study.

Keywords

Dexmedetomidine
Midazolam
Extubation
Withdrawal Reactions from Anesthesia
Lumbar Disc
  1. Finnerty CC, Mabvuure NT, Ali A, Kozar RA, Herndon DN. The surgically induced stress response. JPEN J Parenter Enteral Nutr. 2013 Sep;37(5 Suppl):21S-9S.
  2. Malvi A, Jain S. Laryngeal Trauma, Its Types, and Management. Cureus. 2022 Oct 3;14(10):e29877.
  3. Montaseri, M, Shadfard Z, Taghizadeganzadeh M, Moarefi F, Pishgar, Z. Surveying the Degree of Observance of principle's Surgical Safety, according to the World Health Organization check list in teaching hospitals of jahrom in 2015. Education and Ethics In Nursing, 2017; 6(3-4): 14-21.
  4. Behl TA, Stamford BA, Moffatt RJ. The Effects of Smoking on the Diagnostic Characteristics of Metabolic Syndrome: A Review. Am J Lifestyle Med. 2022 Jun 28;17(3):397-412.
  5. Drozdz D, Alvarez-Pitti J, Wójcik M, Borghi C, Gabbianelli R, Mazur A, Herceg-Čavrak V, Lopez-Valcarcel BG, Brzeziński M, Lurbe E, Wühl E. Obesity and Cardiometabolic Risk Factors: From Childhood to Adulthood. Nutrients. 2021 Nov 22;13(11):4176.
  6. Tarwade P, Smischney NJ. Endotracheal intubation sedation in the intensive care unit. World J Crit Care Med. 2022 Jan 9;11(1):33-39.
  7. Mao S, Du X, Ma J, Zhang G, Cui J. A
    comparison between laryngeal mask airway and endotracheal
    intubation for anaesthesia in adult patients undergoing NUSS
    procedure. J Thorac Dis 2018;10(6):3216-322
  8. Kim, Young Sung MD, PhDa; Chang, Hae Wone MD, PhDb; Kim, Heezoo MD, PhDa; Park, Jong Sun MDa; Won, Young Ju MD, PhDa,∗. Comparison of the effects of dexmedetomidine and remifentanil on perioperative hemodynamics and recovery profile of patients undergoing laryngeal microsurgery: A prospective randomized double-blinded study. Medicine.2021; 100(34):p e27045
  9. Huang J, Chopra N, Yepuri N, Kinthala S. Emergence Agitation and Anesthetic Considerations in the Management of Patients With Post-Traumatic Stress Disorder: A Report of Two Cases and a Review of the Literature. Cureus. 2023 Jan 15;15(1):e33794.
  10. Wong TH, Weber G, Abramowicz AE. Smooth Extubation and Smooth Emergence Techniques: A Narrative Review. Anesthesiol Res Pract. 2021 Jan 15;2021:8883257.
  11. Masoudifar, M., Nazemroaya, B., Rahimi, Z., Khademi, M. Effects of midazolam and dexmedetomidine on sedation levels, hemodynamics and, complications under brain stereotaxic surgery.. Jundishapur Scientific Medical Journal, 2019; 18(3): 311-317.
  12. Akbari M R, Alinaghimaddah S M, Ownagh V, Kazemnejad Tabrizi K, HatamiS E. Comparison of the Effects of Midazolam, Propofol, and Dexmedetomidine on Hemodynamics Variation in Patients Undergoing Cataract Surgery under Local Anesthesia at 5 Azar Hospital in Gorgan in 2021-2022. J North Khorasan Univ Med Sci. 2022;14(4):47-54.
  13. Kaye AD, Chernobylsky DJ, Thakur P, Siddaiah H, Kaye RJ, Eng LK, Harbell MW, Lajaunie J, Cornett EM. Dexmedetomidine in Enhanced Recovery After Surgery (ERAS) Protocols for Postoperative Pain. Curr Pain Headache Rep. 2020 Apr 2;24(5):21.
  14. Peter J-U, Dieudonné P, Zolk O. Pharmacokinetics, Pharmacodynamics, and Side Effects of Midazolam: A Review and Case Example. Pharmaceuticals. 2024; 17(4):473.
  15. Boku A, Hanamoto H, Oyamaguchi A, Inoue M, Morimoto Y, Niwa H. Eficácia de dexmedetomidina para o surgimento de agitação em lactentes submetidos à palatoplastia: estudo clínico randomizado [Effectiveness of dexmedetomidine for emergence agitation in infants undergoing palatoplasty: a randomized controlled trial]. Rev Bras Anestesiol. 2016 Jan-Feb;66(1):37-43.
  16. Sahraie, R., Eftekharian, F., Damshenas, M. H., Kalani, N., Rastgarian, A. Comparison of Postoperative Nausea and Vomiting in Percutaneous Nephrolithotomy (PCNL) through Two Supine and Prone Methods: A Clinical Trial Study. medical journal of mashhad university of medical sciences, 2020; 63(1): 2230-2237
  17. Yousefi A, Bagheri H, Nourian, J, Khosravi A, Khatibi M. Effect of intravenous and intra-cuff hydrocortisone on the severity of cough after general anesthesia using endotracheal tube. Avicenna J Nurs Midwifery Care 2017; 25 (3) :1-7
  18. Iftikhar T, Taqi A, Sibtain A, Anjum S, Awan I. Oral gabapentin reduces hemodynamic response to direct laryngoscopy and tracheal intubation. Anaesth Pain Intensive Care. 2011;15(1):17- 20.
  19. Memis D, Turan A, Karamanlioglu B, Seker S, Ture M. Gabapentin reduces cardiovascular responses to laryngoscopy and tracheal intubation. Eur J Anaesthesiol. 2006;23(8):686-90.

Home

Guide for Authors

Submit Manuscript

Contact Us