Abstract
Background and Objective: Several studies have shown that topical and intravenous Dexmedetomidine and Lidocaine can decrease pain and reduce consumption of analgesic drugs. However, Lidocaine may be accompanied with several side effects such as respiratory suppression, seizure, and cardiac arrhythmias. On the other hand, Dexmedetomidine has favorable properties such as low risk of apnea, analgesia, sympatholysis, and sedation. Therefore, the aim of this study was to compare the effects of nebulized Dexmedetomidine and nebulized Lidocaine on hemodynamic characteristics of the patients undergoing bronchoscopy. Materials and Methods: In the present randomized, double-blind study; 75 children (1-6 years old) undergoing fiber-optic bronchoscopy were allocated to three groups. Group 1 received nebulized solution containing 2 µg/kg of Dexmedetomidine. Group 2 received nebulized solution containing 4 mg/kg of Lidocaine 1. Group 3 received nebulized solution containing 0.9 of normal saline as the control group. Heart rate, mean arterial blood pressure and SpO2, Bispectral Index (BIS) were measured and compared. BIS, indicating the depth of anesthesia was considered as a confounding factor. Statistical analysis was performed using SPSS software. Results: The mean of arterial blood pressure and heart rate was significantly lower in group 1 compared to groups 2 and 3 during bronchoscopy (P< 0.05). Blood oxygen saturation and sedation scores were significantly higher in group 1 compared to the other groups during bronchoscopy (P< 0.05). Furthermore, the hemodynamic parameters were more stable in group 1 compared to the other groups during recovery. Conclusion: Premedication with nebulized Dexmedetomidine was significantly associated with more stable hemodynamic parameters and lower risk of side effects compared to nebulized Lidocaine in children undergoing fiberoptic bronchoscopy.
Highlights
Fiber-optic bronchoscopy is a relatively safe method which is widely used nowadays for therapeutic and diagnostic aims [1]
Premedication with nebulized Dexmedetomidine was significantly associated with more stable hemodynamic parameters and lower risk of side effects compared to nebulized Lidocaine in children undergoing fiberoptic bronchoscopy
A significant difference was observed between the three groups regarding heart rate at the beginning of the bronchoscopy and during the bronchoscopy; meaning that the heart rate in the third group was higher than the second group, and was higher in the second group compared to the first group (P
Summary
Fiber-optic bronchoscopy is a relatively safe method which is widely used nowadays for therapeutic and diagnostic aims [1]. One of the most important side effects of bronchoscopy is cerebral hypoxia which might be induced by various factors such as consumption of sedatives, partial obstruction of the airway, inappropriate ventilation and reflexive response to bronchoscopy and lavage [2]. To reduce the need for sedative drugs, local anesthesia of the airway was administered. The anesthetic goals in children undergoing bronchoscopy include reducing the pressure by the patient, coughing during intubation, stabilizing patient’s hemodynamic status and rapid recovery of the airway reflexes after the bronchoscopy [5]. Several studies have shown that topical and intravenous Dexmedetomidine and Lidocaine can decrease pain and reduce consumption of analgesic drugs. The aim of this study was to compare the effects of nebulized Dexmedetomidine and nebulized Lidocaine on hemodynamic characteristics of the patients undergoing bronchoscopy
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