Anesthesia, Dexmedetomidine, Obesity, Morbid
Conditions
Brief summary
Compare the effects of two different doses of dexmedetomidine infusion on oxygenation as a primary outcome and on lung mechanics, quality of recovery and perioperative analgesia as secondary outcomes in morbidly obese patients with restrictive lung disease undergoing abdominal surgery.
Detailed description
Dexmedetomidine is a selective α2 receptor agonist and has sympatholytic, analgesic, anti-inflammatory and sedative properties. Dexmedetomidine decreased dead space and improved both lung compliance and oxygenation in chronic obstructive pulmonary disease (COPD) patients undergoing lung cancer surgery. The effects of dexmedetomidine on oxygenation and lung mechanics had been investigated in obstructive lung disease, but there are little information about its effect in morbidly obese patients with restrictive lung disease .
Interventions
DRUGDexmedetomidine 0.6
Patients received a bolus dose of 1μg/kg Dexmedetomidine, 15 minutes after endotracheal intubation over 10 minutes followed by infusion of 0.6 μg/kg/hr for one hour.
DRUGDexmedetomidine 0.3
Patients received a bolus dose of 1μg/kg Dexmedetomidine, 15 minutes after endotracheal intubation over 10 minutes followed by infusion of 0.3 μg/kg/hr for one hour.
DRUGSaline
Patients received over 10 minutes comparable volume of normal saline (0.9%) 15 min after endotracheal intubation followed by infusion.
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Body Mass Index above 40 kg/m2 with restrictive lung disease((forced vital capacity) \<70% in pre-operative pulmonary function tests), of American Society of anesthesiologists (ASA) physical status II and III. * Aged 18-50 years. * Scheduled for abdominal surgery.
Exclusion criteria
* Patients with Forced expiratory volume1/forced vital capacity\<7. * Uncontrolled cardiac, respiratory, hepatic or renal diseases. * Allergy to the study drug
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative oxygenation | Intraoperative | Intraoperative oxygenation was assessed by P/F ratio (Arterial oxygen tension/fraction of inspired oxygen) at baseline and the end of drug infusion. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-operative pain | 24 hour postoperatively | Assessment of post-operative pain by The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. no pain) to '10' representing the other pain extreme |
| Dead space (dead space to tidal volume) | Intraoperative | Physiological dead space was calculated by Hardman and Aitkenhead equation: (dead space to tidal volume) = 1.14(PaCO2 -EtCO2)/PaCO2- 0.005 dead space (%) = dead space by end of infusion - dead space at the base line / dead space by the end of drug infusion % |
| Quality of recovery score | 24 hours Postoperatively | The Quality of recovery score scale provides a score ranging from 0 to 150, with a high score indicating a good quality of recovery |
| Dynamic Lung compliance | Intraoperative | Dynamic lung compliance=tidal volume/ (peak airway pressure- Positive end-expiratory pressure). |
| Static lung compliance | Intraoperative | Static lung compliance =tidal volume /(plateau pressure - Positive end-expiratory pressure). |
| Lung compliance | 24 hours | compliance = dynamic compliance at the end of the drug infusion - baseline dynamic compliance. |
| Plateau pressure | Intraoperative | Plateau pressure was calculated by increasing end inspiratory pause to 30-40%. |
| Time to first rescue analgesia | 24 hours Postoperatively | Time to first rescue analgesia as morphine consumption was recorded |
Countries
Egypt
Outcome results
None listed