Dexmedetomidine combined with endotracheal intubation laryngeal mask in anesthesia of patients with a cervical spine injury

Z. Liu, X. Wang, L.-P. Wang, Y. Bai, Y.-X. Li, X.-N. Gao, Y.-B. Sun

Department of Anesthesiology, Chengde Central Hospital, Chengde, China. sun0403@163.com

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• Anesthesiology

OBJECTIVE: Tracheal intubation under general anesthesia is more likely to aggravate the injury of the cervical spine and spinal cord. We aim to explore the effect of dexmedetomidine combined with intubating laryngeal mask airway (ILMA) on anesthesia and stress response in patients with a cervical spine injury.

PATIENTS AND METHODS: One hundred twenty patients were retrospectively allocated into the control group (midazolam + ILMA) and intervention group (dexmedetomidine + ILMA). Their hemodynamics at T1 (before anesthesia induction), T2 (1 minute after anesthesia induction), T3 (immediately after intubation), and T4 (1 min after successful intubation) were also compared.

RESULTS: The heart rate (HR) and mean arterial pressure (MAP) of patients in the observation group were lower than those in the control group from T3 to T4 (both p = 0.000). Ramsay’s score in the observation group was higher than the control group from T3 to T4 (both p= 0.000). No difference was observed in PaO2, PaCO2, and pH between the 2 groups. The level of serum cortisol (COR), plasma epinephrine (E), and norepinephrine (NE) in the observation group were lower than in the control group (p < 0.05) after induction.

CONCLUSIONS: Dexmedetomidine combined with ILMA could improve the first intubation success rate and tolerance in patients with cervical spine injury by maintaining stable hemodynamics and reducing the stress response of patients.

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