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학술저널
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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제57권 제4호
발행연도
2016.1
수록면
980 - 986 (7page)

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Purpose: During emergence from anesthesia for a craniotomy, maintenance of hemodynamic stability and prompt evaluation of neurological status is mandatory. The aim of this prospective, randomized, double-blind study was to compare the effects of dexmedetomidineand remifentanil on airway reflex and hemodynamic change in patients undergoing craniotomy. Materials and Methods: Seventy-four patients undergoing clipping of unruptured cerebral aneurysm were recruited. In the dexmedetomidinegroup, patients were administered dexmedetomidine (0.5 μg/kg) for 5 minutes, while the patients of the remifentanilgroup were administered remifentanil with an effect site concentration of 1.5 ng/mL until endotracheal extubation. The incidenceand severity of cough and hemodynamic variables were measured during the recovery period. Hemodynamic variables, respiration rate, and sedation scale were measured after extubation and in the post-anesthetic care unit (PACU). Results: The incidence of grade 2 and 3 cough at the point of extubation was 62.5% in the dexmedetomidine group and 53.1% in the remifentanil group (p=0.39). Mean arterial pressure (p=0.01) at admission to the PACU and heart rate (p=0.04 and 0.01, respectively)at admission and at 10 minutes in the PACU were significantly lower in the dexmedetomidine group. Respiration rate was significantly lower in the remifentanil group at 2 minutes (p<0.01) and 5 minutes (p<0.01) after extubation. Conclusion: We concluded that a single bolus of dexmedetomidine (0.5 μg/kg) and remifentanil infusion have equal effectivenessin attenuating coughing and hemodynamic changes in patients undergoing cerebral aneurysm clipping; however, dexmedetomidineleads to better preservation of respiration.

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