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Effects of Dexmedetomidine on Changes in Heart Rate Variability and Hemodynamics During Tracheal Intubation.

Authors
 Jin Sun Cho  ;  Shin Hyung Kim  ;  Seokyung Shin  ;  Hui-Nam Pak  ;  Shi Joon Yang  ;  Young Jun Oh 
Citation
 American Journal of Therapeutics, Vol.23(2) : 369-376, 2016 
Journal Title
 American Journal of Therapeutics 
ISSN
 1075-2765 
Issue Date
2016
MeSH
Adrenergic alpha-2 Receptor Agonists/pharmacology* ; Adult ; Dexmedetomidine/pharmacology* ; Electrocardiography/drug effects ; Female ; Heart Rate/drug effects* ; Hemodynamics/drug effects* ; Humans ; Intubation, Intratracheal* ; Male ; Middle Aged ; Sympathetic Nervous System/physiology
Keywords
dexmedetomidine ; fentanyl ; heart rate variability ; intubation ; intratracheal ; QT interval
Abstract
Sympathetic hyperactivation during tracheal intubation prolongs the QT interval and increases the risk of arrhythmias. We investigated if dexmedetomidine pretreatment affected autonomic nervous system balance and QT intervals during intubation. Sixty-six patients were randomized to receive 1.0 μg/kg fentanyl (group F, n = 22), 0.5 μg/kg dexmedetomidine (group D0.5, n = 22), or 1.0 μg/kg dexmedetomidine (group D1.0, n = 22) before induction. Autonomic nervous system balance was assessed by the ratio of low-frequency/high-frequency (LF/HF) power for heart rate variability at baseline (T0), before intubation (T1), and after intubation (T2). QT intervals were corrected by the Bazett's formula (QTc) and compared at baseline, before intubation, and 1, 2, and 3 minutes after intubation. The LF/HF ratio was higher after intubation compared with that at T0 in group F (P < 0.001). There were no significant changes in groups D0.5 and D1.0. The LF/HF ratio was significantly higher in group F compared with those in groups D0.5 and D1.0 after intubation (7.9 vs. 2.1 and 2.5; P < 0.001). The heart rate was increased for 3 minutes after intubation in group F, whereas only for 1 minute after intubation in groups D0.5 and D1.0, compared with that at baseline. More patients in group F had QTc greater than 440 ms compared with that in group D0.5 or D1.0 (8 vs. 1 and 2; P = 0.005) at 1 minute after intubation. In contrast to 1.0 μg/kg fentanyl, pretreatment with 0.5 or 1.0 μg/kg dexmedetomidine suppressed sympathetic hyperactivity and attenuated QTc prolongation during intubation.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00045391-201603000-00009&LSLINK=80&D=ovft
DOI
10.1097/MJT.0000000000000074
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김신형(Kim, Shin Hyung) ORCID logo https://orcid.org/0000-0003-4058-7697
박희남(Pak, Hui Nam) ORCID logo https://orcid.org/0000-0002-3256-3620
신서경(Shin, Seokyung) ORCID logo https://orcid.org/0000-0002-2641-0070
양시준(Yang, Shi Joon)
오영준(Oh, Young Jun) ORCID logo https://orcid.org/0000-0002-6258-5695
조진선(Cho, Jin Sun) ORCID logo https://orcid.org/0000-0002-5408-4188
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146530
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