Effect of Dexmedetomidine After Thyroidectomy
Condition: Thyroid Tumor
MeSH terms: Thyroid Neoplasms
Study type: Interventional

Summary: 
      The purpose of the present study was to compare the effect of dexmedetomidine which is
      administered during emergence in adult patients undergoing elective thyroidectomy on smooth
      emergence form general anesthesia (reducing agitation or coughing, signs of hypertension or
      tachycardia, or etc.) and postoperative outcome (postoperative bleeding and hospital
      staying).
    

Detailed description: 
      Smooth emergence from general anaesthesia after surgery is important to prevent potentially
      dangerous effects such as hypertension, tachycardia, myocardial ischaemia, arrhythmias and
      increased intracranial and intra-abdominal pressure. After thyroidectomy, activities during
      emergence such as agitation or coughing, signs of hypertension or tachycardia, or etc. may
      lead to postoperative bleeding, resulting in acute airway obstruction or reoperation.

      The purpose of the present study was to compare the effect of dexmedetomidine which is
      administered during emergence in adult patients undergoing elective thyroidectomy on smooth
      emergence form general anesthesia and postoperative outcome.
    

Intervention name(s): Desflurane; Remifentanil; Thyroidectomy; Vital signs; Cough reflex; Ramsay Sedation Scale; Extubation time and Recovery time; Visual analogue scale; Postoperative bleeding; Postoperative complications; Time to remove drainage and duration of hospital staying; Dexmedetomidine; Normal saline
Intervention type(s): Drug; Drug; Procedure; Other; Behavioral; Behavioral; Other; Behavioral; Other; Other; Other; Drug; Drug
Intervention description(s): Anesthesia is maintained with desflurane; Remifentanil is infused for the maintenance of anesthesia during surgery and discontinued 15 min before end of surgery; The aim of this study is evaluation of effect of dexmedetomidine on emergence response and postoperative outcome after thyroidectomy; Systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate are measured before infusion of testing drugs, after infusion of them (5 min, 10 min, and 15 min), during extubation (0 min and 5 min after extubation), and at recovery room.
And the complications such as hypotension, hypertension, bradycardia, tachycardia, and desaturation after infusion of testing drugs are observed.; During recovery from anesthesia at operation room, cough reflex is measured and rated. [Grade 0, no cough; Grade 1, single cough with mild severity; Grade 2, cough persistence less than 5 s with moderate severity; Grade 3, severe, persistent cough for more than 5 s (bucking)]; When the patient has fully awaken and transferred to the recovery room, Ramsay Sedation Scale is measured.
Awake Patient anxious and agitated or restless or both!
Patient cooperative, oriented and tranquil!
Patient responds to commands only!
Asleep A brisk response to a light glabellar tap or loud auditory stimulus!
A sluggish response to a light glabellar tap or loud auditory stimulus!
No response to a light glabellar tap or loud auditory stimulus; The time from discontinuing anesthetic gas to endotracheal extubation is measured.
And the time from the discontinuing of anesthetic gas to transferring to the recovery room is also measured.; The severity of pain after surgery is measured by VAS (at recovery room, POD 1, POD 2, and POD 3); The amount of postoperative bleeding which is collected in the barovac is measured.; Postoperative complications after thyroidectomy such as hoarseness and hematoma, and reoperation due to such complication is observed.; The time from the end of surgery to remove drainage is measured. And the duration of hospital staying is measured.; Dexmedetomidine has started infusion for 15 min (rate of 0.6 ug/kg/hr) before end of surgery as experimental intervention; Normal saline has started infusion for 15 min (as same rate of dexmedetomidine) before end of surgery as control intervention
Other intervention name(s): Anesthetic gas; Opioid; Surgery; Hemodynamics; RSS; VAS; Precedex; NS
Intervention MeSH terms: Dexmedetomidine; Remifentanil; Desflurane; Anesthetics; Anesthetics, Inhalation
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Prevention