Gland and Hormone Related Diseases

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Thyroid Diseases

Thyroid Neoplasms

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Head and Neck Neoplasms

Endocrine System Diseases

Central Nervous System Depressants

All Drugs and Chemicals

Analgesics

Anesthetics

Dexmedetomidine

Analgesics, Opioid

Remifentanil

Desflurane

Anesthetics, Inhalation

Hypnotics and Sedatives

Analgesics, Non-Narcotic

Adrenergic Agents

Adrenergic alpha-Agonists

Adrenergic Agonists

Neurotransmitter Agents

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Anesthetics, General

After induction of anesthesia, anesthesia is maintained with desflurane and remifentanil during thyroidectomy.

Fifteen minutes before the end of surgery, infusion of remifentanil for surgery is discontinued.

Then, dexmedetomidine has started infusion for 15 min (rate of 0.6 ug/kg/hr). Vital signs and complications of testing drugs are measured before and after infusion of testing drugs.

Five minutes before the end of surgery, anesthetic gas (desflurane) is discontinued.

After patient has awake, extubation has done. Extubation time and Recovery time,Cough reflex,Ramsay Sedation Scale, Visual analogue scale, and surgical outcomes such as postoperative bleeding, time to remove drainage and duration of hospital staying, postoperative complications are measured until POD#3.

After induction of anesthesia, anesthesia is maintained with desflurane and remifentanil during thyroidectomy.

Fifteen minutes before the end of surgery, infusion of remifentanil for surgery is discontinued. Then, normal saline has started infusion for 15 min (same rate as Group D). Vital signs and complications of testing drugs are measured before and after infusion of testing drugs.

Five minutes before the end of surgery, anesthetic gas (desflurane) is discontinued.

After patient has awake, extubation has done. Extubation time and Recovery time,Cough reflex,Ramsay Sedation Scale, Visual analogue scale, and surgical outcomes such as postoperative bleeding, time to remove drainage duration of hospital staying, postoperative complications are measured until POD#3.

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

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.

Vital signs

During recovery from anesthesia at operation room, cough reflex is measured and rated. \[Grade 0, no cough; Grade 1, single cough with mild severity; Grade 2, cough persistence less than 5 s with moderate severity; Grade 3, severe, persistent cough for more than 5 s (bucking)\]

Cough reflex

When the patient has fully awaken and transferred to the recovery room, Ramsay Sedation Scale is measured.

1. Awake Patient anxious and agitated or restless or both!
2. Patient cooperative, oriented and tranquil!
3. Patient responds to commands only!
4. Asleep A brisk response to a light glabellar tap or loud auditory stimulus!
5. A sluggish response to a light glabellar tap or loud auditory stimulus!
6. No response to a light glabellar tap or loud auditory stimulus

Ramsay Sedation Scale

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.

Extubation time and Recovery time

The severity of pain after surgery is measured by VAS (at recovery room, POD 1, POD 2, and POD 3)

Visual analogue scale

The amount of postoperative bleeding which is collected in the barovac is measured.

Postoperative bleeding

Postoperative complications after thyroidectomy such as hoarseness and hematoma, and reoperation due to such complication is observed.

Postoperative complications

The time from the end of surgery to remove drainage is measured. And the duration of hospital staying is measured.

Time to remove drainage and duration of hospital staying

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

Normal saline

Ki Tae Jung, M.D.

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).

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.

Effect of Dexmedetomidine After Thyroidectomy

Effect of Dexmedetomidine Infusion for Postoperative Outcome and Smooth Emergence After Thyroidectomy

Systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate

Hypertension, hypotension, bradycardia, tachycardia, and desaturation after infusion of dexmedetomidine or normal saline

Postoperative bleeding: Sum of bleeding via barovac

time to extubation from the end of surgery

time to transfer to recovery room from the end of surgery

Coughing Response during recovery from anesthesia

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Effect of Dexmedetomidine After Thyroidectomy	NCT02412150	Thyroid Tumor	Desflurane Remifentanil Thyroidectomy Vital signs Cough reflex Ramsay Sedation... Extubation time... Visual analogue... Postoperative b... Postoperative c... Time to remove ... Dexmedetomidine Normal saline	20 Years - 60 Years	Chosun University Hospital
Effect of Dexmedetomidine After Thyroidectomy	NCT02412150	Thyroid Tumor	Desflurane Remifentanil Thyroidectomy Vital signs Cough reflex Ramsay Sedation... Extubation time... Visual analogue... Postoperative b... Postoperative c... Time to remove ... Dexmedetomidine Normal saline	20 Years - 60 Years	Chosun University Hospital

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