Metoprolol for prevention of bucking at orotracheal extubation : a double-blind, placebo-controlled randomised trial
Copyright © 2023. Published by Elsevier España S.L.U..
BACKGROUND: Respiratory responses to extubation can cause serious postoperative complications. Beta-blockers, such as metoprolol, can interfere with the cough pathway. However, whether metoprolol can effectively control respiratory reflexes during extubation remains unclear. The objective of this study is to evaluate the efficacy of intravenous metoprolol in attenuating respiratory responses to tracheal extubation.
METHODS: Randomized, double-blinded, placebo-controlled trial.
SETTING: Tertiary referral center located in Brasília, Brazil. Recruitment: June 2021 to December 2021.
SAMPLE: 222 patients of both sexes with an American Society of Anesthesiologists (ASA) physical status I-III aged 18-80 years. Patients were randomly assigned to receive intravenous metoprolol 5 mg IV or placebo at the end of surgery. The primary outcome was the proportion of patients who developed bucking secondary to endotracheal tube stimulation of the tracheal mucosa during extubation. Secondary outcomes included coughing, bronchospasm, laryngospasm, Mean Blood Pressure (MAP), and Heart Rate (HR) levels.
RESULTS: Two hundred and seven participants were included in the final analysis: 102 in the metoprolol group and 105 in the placebo group. Patients who received metoprolol had a significantly lower risk of bucking (43.1% vs. 64.8%, Relative Risk [RR = 0.66], 95% Confidence Interval [95% CI 0.51-0.87], p = 0.003). In the metoprolol group, 6 (5.9%) patients had moderate/severe coughing compared with 33 (31.4%) in the placebo group (RR = 0.19; 95% CI 0.08-0.43, p < 0.001).
CONCLUSION: Metoprolol reduced the risk of bucking at extubation in patients undergoing general anesthesia compared to placebo.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
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| Enthalten in: |
Brazilian journal of anesthesiology (Elsevier) - 74(2024), 2 vom: 29. März, Seite 744455 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
de Queiroz, Murilo Neves [VerfasserIn] |
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| Links: |
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| Themen: |
Airway extubation |
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| Anmerkungen: |
Date Completed 25.03.2024 Date Revised 28.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.bjane.2023.07.012 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM360411762 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023. Published by Elsevier España S.L.U. | ||
| 520 | |a BACKGROUND: Respiratory responses to extubation can cause serious postoperative complications. Beta-blockers, such as metoprolol, can interfere with the cough pathway. However, whether metoprolol can effectively control respiratory reflexes during extubation remains unclear. The objective of this study is to evaluate the efficacy of intravenous metoprolol in attenuating respiratory responses to tracheal extubation | ||
| 520 | |a METHODS: Randomized, double-blinded, placebo-controlled trial | ||
| 520 | |a SETTING: Tertiary referral center located in Brasília, Brazil. Recruitment: June 2021 to December 2021 | ||
| 520 | |a SAMPLE: 222 patients of both sexes with an American Society of Anesthesiologists (ASA) physical status I-III aged 18-80 years. Patients were randomly assigned to receive intravenous metoprolol 5 mg IV or placebo at the end of surgery. The primary outcome was the proportion of patients who developed bucking secondary to endotracheal tube stimulation of the tracheal mucosa during extubation. Secondary outcomes included coughing, bronchospasm, laryngospasm, Mean Blood Pressure (MAP), and Heart Rate (HR) levels | ||
| 520 | |a RESULTS: Two hundred and seven participants were included in the final analysis: 102 in the metoprolol group and 105 in the placebo group. Patients who received metoprolol had a significantly lower risk of bucking (43.1% vs. 64.8%, Relative Risk [RR = 0.66], 95% Confidence Interval [95% CI 0.51-0.87], p = 0.003). In the metoprolol group, 6 (5.9%) patients had moderate/severe coughing compared with 33 (31.4%) in the placebo group (RR = 0.19; 95% CI 0.08-0.43, p < 0.001) | ||
| 520 | |a CONCLUSION: Metoprolol reduced the risk of bucking at extubation in patients undergoing general anesthesia compared to placebo | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Airway extubation | |
| 650 | 4 | |a Cough | |
| 650 | 4 | |a Hypertension | |
| 650 | 4 | |a Metoprolol | |
| 650 | 4 | |a Tachycardia and hypertension | |
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| 700 | 1 | |a de Matos, Maurício Vargas |e verfasserin |4 aut | |
| 700 | 1 | |a Lino, Rafael Santos |e verfasserin |4 aut | |
| 700 | 1 | |a de Carvalho, Luiz Sérgio Fernandes |e verfasserin |4 aut | |
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