Comparison of the effects of dexmedetomidine and remifentanil on potential extreme haemodynamic and respiratory response following mask ventilation and laryngoscopy in patients with mandibular fractures

T. Ciftci, S. Erbatur, M. Ak

Department of Anesthesiology and Reanimation, Dicle University Medical Faculty, Diyarbakır, Turkey. dr.taner.ciftci@gmail.com

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• Pharmacology

OBJECTIVE: The safety profile and efficacy were compared for remifentanil and dexmedetomidine with respect to haemodynamic and respiratory response during mask ventilation and laryngoscopy in patients with mandibular fractures.

PATIENTS AND METHODS: Seventy patients undergoing elective mandibular fracture surgery were randomly assigned to the remifentanil group (Group R, n = 35) or the dexmedetomidine group (Group D, n = 35). The primary outcomes were preoperative pain scores caused by jaw movement; haemodynamic response; intubation score; and side effects, such as the incidence of oxygen desaturation and muscle rigidity. Other side effects, such as tachycardia, bradycardia, hypertension and hypotension, were also compared.

RESULTS: Preoperative pain scores caused by jaw movement were significantly high for both groups, but there were no statistically significant differences between the groups. The incidence of oxygen desaturation and muscle rigidity was significantly lower in Group D than in Group R (p = 0.025). No significant differences existed between the groups in terms of intubation score, haemodynamics, and other side effects (p > 0.05).

DISCUSSION: Dexmedetomidine and remifentanil had equal effectiveness on the control of haemodynamic response due to mask ventilation and intubation in patients with mandibular fractures. However, at the doses used in this study, dexmedetomidine had a significant advantage over remifentanil in terms of respiratory stability.

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