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

 Jin Sun Cho  ;  Shin Hyung Kim  ;  Seokyung Shin  ;  Hui-Nam Pak  ;  Shi Joon Yang  ;  Young Jun Oh 
 AMERICAN JOURNAL OF THERAPEUTICS, Vol.23(2) : 369-376, 2016 
Journal Title
Issue Date
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
dexmedetomidine ; fentanyl ; heart rate variability ; intubation ; intratracheal ; QT interval
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.
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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
Kim, Shin Hyung(김신형) ORCID logo https://orcid.org/0000-0003-4058-7697
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Shin, Seokyung(신서경) ORCID logo https://orcid.org/0000-0002-2641-0070
Yang, Shi Joon(양시준)
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Cho, Jin Sun(조진선) ORCID logo https://orcid.org/0000-0002-5408-4188
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