The Comparison of the Effects of Fentanyl and Dexmedetomidine on Hemodynamic Stability in Patients undergoing Stereotactic Surgery

Authors

1 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: In patients undergoing surgery, hemodynamic disorders are common. Therefore, we decided to compare the effects of fentanyl and dexmedetomidine on hemodynamic changes in patients undergoing Stereotactic surgery. 
Methods: In this double blinded clinical trial, 68 candidates for Stereotactic Surgery in Alzahra Hospital in 2017 enrolled in the study. Patients were randomly divided into two groups; the first group was given bolus of 2 μg / kg fentanyl, and in the second group a loading dose of 1 μgr / kg / 10 min, followed by maintenance dose of: 0.5 μg / kg / h of dexmedetomidine was admininstered intravenously. The Dexmedetomidine was infused immediately 
following anesthesia induction. The hemodynamic variables in the two groups were evaluated.
Findings: There was no significant difference between the two groups based on systolic and diastolic blood pressure and oxygen saturation at different times. The heart rate in the dexmedetomidine group at 30, 60 and 90 minutes was significantly lower than fentanyl. On the other hand, there was no significant difference between the two groups with regards to pH, Pco2 and HCO3 before and after operation and recovery time.
Conclusion: Both dexmedetomidine and fentanyl are two effective drugs for controlling hemodynamics parameters in patients undergoing stereotactic surgery, but dexmedetomidine drug reduces heart rate significantly compared with fentanyl.

Keywords

References

  1. Bruder NJ. Awakening management after neurosurgery for intracranial tumours. Curr Opin Anaesthesiol 2002; 15(5): 477-82.
  2. Grabowska-Gaweł A, Porzych K, Piskunowicz G. Risk factors and frequency of postoperative nausea and vomiting in patients operated under general anesthesia. Przegl Lek 2006; 63(2): 72-6. [In Polish].
  3. Wong JM, Panchmatia JR, Ziewacz JE, Bader AM, Dunn IF, Laws ER, et al. Patterns in neurosurgical adverse events: intracranial neoplasm surgery. Neurosurg Focus 2012; 33(5): E16.
  4. Giovannitti Jr JA, Thoms SM, Crawford JJ. Alpha-2 adrenergic receptor agonists: a review of current clinical applications. Anesth Prog 2015; 62(1): 31-9.
  5. Mavropoulos G, Minguet G, Brichant JF. Alpha-2 adrenoreceptor agonists in anaesthesia and intensive care medicine. Rev Med Liege 2014; 69(2): 97-101. [In French].
  6. Samir GM, Ibrahim DA. Dexmedetomidine versus propofol for sedation in stereotactic brain biopsy: a comparative study. Ain Shams J Anesthesiol 2019; 11(1): 7.
  7. George C, Ramesh V, Gangadharan JL, Konar SK. Airway management during anesthesia for stereotactic placement of intratumoral drug delivery system in a patient with anaplastic astrocytoma. J Anaesthesiol Clin Pharmacol 2012; 28(1):
    129-30.
  8. Soliman RN, Hassan AR, Rashwan AM, Omar AM. Prospective, randomized study to assess the role of dexmedetomidine in patients with supratentorial tumors undergoing craniotomy under general anaesthesia.
    Middle East J Anaesthesiol 2011; 21(3): 325-34.
  9. Sassi M, Zekaj E, Grotta A, Pollini A, Pellanda A, Borroni M, et al. Safety in the use of dexmedetomidine (precedex) for deep brain stimulation surgery: our experience in 23 randomized patients. Neuromodulation 2013; 16(5): 401-6.
  10. Amri P, Nahrini S, Hajian-Tilaki K, Hamidian M, Alipour SF, Hamidi SH, et al. Analgesic effect and hemodynamic changes due to dexmedetomidine versus fentanyl during elective colonoscopy: a double-blind randomized clinical trial. Anesth Pain Med 2018; 8(6): e81077.
  11. Vaswani JP, Debata D, Vyas V, Pattil S. Comparative study of the effect of dexmedetomidine vs. fentanyl on haemodynamic response in patients undergoing elective laparoscopic surgery. J Clin Diagn Res 2017; 11(9): Uc04-Uc08.
  12. Hassani V, Farhadi M, Mohseni M, Safaeian R, Nikoobakht N, Sehat Kashani S, et al. Comparing the efficacy of dexmedetomidine versus fentanyl and midazolam during awake fiberoptic intubation. AACC 2018; 4(4): 538-41.
  13. Jain V, Chandak A, Ghosh A, Golhar M. Comparison of dexmedetomidine and fentanyl for attenuation of the hemodynamic response to laryngoscopy and tracheal intubation. Ain Shams J Anesthesiol2015; 8(2): 236-43.
  14. Gogus N, Akan B, Serger N, Baydar M. The comparison of the effects of dexmedetomidine, fentanyl and esmolol on prevention of hemodynamic response to intubation. Rev Bras Anestesiol 2014; 64(5): 314-9. [In Portuguese].
Journal of Isfahan Medical School
Volume 40, Issue 659
3rd Week, April
March and April 2022
Pages 48-54

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History

  • Receive Date: 14 April 2022
  • Accept Date: 14 April 2022

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