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Intraoperative infusion of dexmedetomidine reduces perioperative analgesic requirements

  • Alp GurbetEmail author
  • Elif Basagan-Mogol
  • Gurkan Turker
  • Fatih Ugun
  • F. Nur Kaya
  • Berin Ozcan
General Anesthesia

Abstract

Purpose

This prospective, randomized, double-blind study was designed to assess whether intraoperative infusion of dexmedetomidine provides effective postoperative analgesia. Postoperative pain scores and morphine consumption were compared in a treated group and a placebo group, both of which received patient-controlled morphine after total abdominal hysterectomy.

Methods

Fifty women were randomly assigned to two groups. Group D (n = 25) received a loading dose of dexmedetomidine 1 μg·kg-1 iv during induction of anesthesia, followed by a continuous infusion at a rate of 0.5 μg·kg-1·hr-1 throughout the operation. Group P (n = 25) received a volume-matched bolus and infusion of placebo (0.9% saline). For each case, heart rate, peripheral oxygen saturation, and systolic and diastolic blood pressure were recorded intraoperatively and for 48 hr postoperatively. Patients used a patient-controlled analgesia device to receive bolus doses of morphine after surgery. Total morphine consumption, pain scores, and sedation scores were recorded for the first 48 hr (two hours in the postanesthesia care unit and 46 hr on the ward).

Results

The groups were similar with respect to mean times to extubation of the trachea. Pain and sedation scores were also similar between groups at all corresponding times throughout the 48-hr period of observation. Group D patients consumed significantly less morphine in the postanesthesia care unit and on the ward (P < 0.05 andP < 0.01, respectively). Fewer patients in Group D experienced itching or nausea/vomiting (P < 0.05).

Conclusion

Continuousiv dexmedetomidine during abdominal surgery provides effective postoperative analgesia, and reduces postoperative morphine requirements without increasing the incidence of side effects.

Keywords

Morphine Clonidine Sevoflurane Dexmedetomidine Mean Arterial Blood Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Une perfusion peropératoire de dexmédétomidine réduit les besoins analgésiques périopératoires

Résumé

Objectif

La présente étude prospective, randomisée et à double insu a été réalisée pour déterminer si une perfusion peropératoire de dexmédétomidine fournit une analgésie postopératoire efficace. Les scores de douleur et la consommation de morphine postopératoires ont été comparés entre un groupe expérimental et un groupe témoin, les deux recevant de la morphine autocontrôlée après une hystérectomie abdominale totale.

Méthode

Cinquante femmes ont été réparties au hasard en deux groupes. Celles du groupe D (n = 25) ont reçu une dose initiale de dexmédétomidine iv de 1 μg·kg-1 pendant l’induction de l’anesthésie, puis une perfusion continue à 0,5 μg·kg-1·hr-1 pendant l’opération. Celles du groupe P (n = 25) ont reçu un bolus de volume apparié et une perfusion de solution saline à 0,9 %. La fréquence cardiaque, la saturation en oxygène du sang périphérique et la tension artérielle systolique et diastolique ont été enregistrées pendant l’opération et pendant 48 h après. Les patientes ont utilisé une pompe d’analgésie autocontrôlée pour recevoir des bolus de morphine postopératoire. La consommation totale de morphine, les scores de douleur et de sédation ont été notés pendant les 48 premières heures (deux heures à la salle de réveil et 46 h à la chambre).

Résultats

Ľextubation endotrachéale a été faite à des temps similaires dans les deux groupes. La douleur et la sédation ont aussi été semblables pour tous les enregistrements faits pendant les 48 h d’observation. Une quantité significativement plus basse de morphine a été utilisée dans le groupe D, en salle de réveil et à la chambre (respectivement P < 0,05 et P < 0,01). Moins de patientes du groupe D ont eu du prurit ou des nausées et des vomissements (P < 0,05).

Conclusion

La perfusion iv continue de dexmédétomidine, administrée pendant une opération abdominale, fournit une analgésie postopératoire efficace et réduit les besoins postopératoires de morphine sans augmenter l’incidence d’effets secondaires.

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Copyright information

© Canadian Anesthesiologists 2006

Authors and Affiliations

  • Alp Gurbet
    • 1
    • 2
    Email author
  • Elif Basagan-Mogol
    • 1
  • Gurkan Turker
    • 1
  • Fatih Ugun
    • 1
  • F. Nur Kaya
    • 1
  • Berin Ozcan
    • 1
  1. 1.Department of Anesthesiology and ReanimationUludag University Faculty of MedicineBursaTurkey
  2. 2.Department of Anesthesiology and ReanimationUniversity Faculty of MedicineGorukle, BursaTurkey

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