Analgesic properties of a dexmedetomidine infusion after uvulopalatopharyngoplasty in patients with obstructive sleep apnea

Abdelmageed, Waleed M.; Elquesny, Kaled M; Shabana, Ramadn I; Abushama, Hossam M; Nassar, Amin

doi:10.4103/1658-354x.82782

Cited by 34 publications

(41 citation statements)

References 21 publications

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“…Dexmedetomidine has been found to reduce both intraoperative and postoperative opioid requirement due to its opioid sparing effect. [1415] In our study, we observed, an increase in the time to receive first rescue analgesia in dexmedetomidine group when compared to NS group. The mean time for rescue analgesia in Group NS was 50 min and all patients received rescue analgesia.…”

Section: Discussionsupporting

confidence: 47%

The effectiveness of intravenous dexmedetomidine on perioperative hemodynamics, analgesic requirement, and side effects profile in patients undergoing laparoscopic surgery under general anesthesia

et al. 2017

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Background:There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively. Dexmedetomidine is one of the α2 agonist drugs which acts at both supraspinal and spinal level and modulate the transmission of nociceptive signals in the central nervous system. The basic effect of dexmedetomidine on the cardiovascular system is to decrease the heart rate and systemic vascular resistance with additional feature of opioid sparing effect. This drug has become an ideal adjuvant during general anesthesia, especially when stress is expected. Hence, the drug was studied in laparoscopic surgeries.Aims and Objectives:(a) To study the effect of dexmedetomidine on hemodynamic parameters during perioperative period in patients undergoing laparoscopic surgery. (b) To study the postoperative sedation score and analgesic requirement. (c) To study the side effect profile of dexmedetomidine.Settings and Design:Randomized double blind controlled trial.Subjects and Methods:After obtaining the Institutional Ethical Clearance, the study was conducted. Forty patients of American Society of Anesthesiologists Class I and II were enrolled in this randomized study. The patients were randomly divided into two groups; group normal saline (NS) and group dexmedetomidine. Patient received either NS or dexmedetomidine in group NS and group dexmedetomidine, respectively, depending upon the allocation. The infusion rate was adjusted according to; loading dose (1 μg/kg) over 10 min and maintenance dose (0.5 μg/kg/h) and perioperative hemodynamics was recorded. Routine general anesthesia was administered in all the patients with conventional technique without deviating from institutional protocols. Postoperatively, Rasmsay sedation score, time taken for request of first analgesic dose, and side effects if any were recorded.Statistical Analysis Used:The categorical factors are represented by the number and frequency (%) of cases. The continuous variables are represented by measures of central frequency and standard deviation. The statistical analysis was done by using unpaired t-test and Chi-square. P < 0.05 was considered statistically significant.Results:Significant hemodynamic changes are observed in NS group during laryngoscopy, intubation, during pneumoperitoneum formation, and during extubation. Hemodynamic stress response in dexmedetomidine group was significantly attenuated. Analgesic requirement during postoperative 24 h were much less in dexmedetomidine group when compared to NS group. No significant side effects were noted except for bradycardia; which was observed in two cases of ...

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Section: Discussionsupporting

confidence: 47%

The effectiveness of intravenous dexmedetomidine on perioperative hemodynamics, analgesic requirement, and side effects profile in patients undergoing laparoscopic surgery under general anesthesia

et al. 2017

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“…Patients undergoing UPPP and tonsillectomy experience unacceptable intense postoperative pain, especially during the first 24 h after surgery . So the treatment of postoperative pain after UPPP and tonsillectomy presents a challenge .…”

Section: Discussionmentioning

confidence: 99%

“…Uvulopalatopharyngoplasty (UPPP) with tonsillectomy is a common method for the treatment of moderate‐to‐severe obstructive sleep apnoea syndrome . Postoperative pain is a common problem . Adult patients undergoing UPPP with tonsillectomy experience an unacceptable level of intense postoperative pain, especially during the first 24 h after surgery .…”

Section: Introductionmentioning

confidence: 99%

“…Adult patients undergoing UPPP with tonsillectomy experience an unacceptable level of intense postoperative pain, especially during the first 24 h after surgery . Treatment of postoperative pain after UPPP and tonsillectomy always presents a challenge . Different drugs and techniques are applied to reduce post UPPP pain .…”

Section: Introductionmentioning

confidence: 99%

“…Treatment of postoperative pain after UPPP and tonsillectomy always presents a challenge . Different drugs and techniques are applied to reduce post UPPP pain . In some procedures, postoperative pain is preventable with adequate analgesic before surgery (preventive analgesia) .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of intravenous vitamin C on postoperative pain in uvulopalatopharyngoplasty with tonsillectomy

Ayatollahi

Farashah

Behdad

et al. 2016

Clinical Otolaryngology

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Perioperative Care of Patients With Obstructive Sleep Apnea Undergoing Upper Airway Surgery

Ravesloot

Raaff

Beek

et al. 2019

JAMA Otolaryngol Head Neck Surg

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IMPORTANCETo date, no consensus exists regarding optimal perioperative care of patients with obstructive sleep apnea (OSA) undergoing upper airway (UA) surgery. These patients are at risk related to anesthesia and postoperative analgesia, among other risks associated with difficult airway control, and may require intensified perioperative management.OBJECTIVE To provide a consensus-based guideline by reviewing available literature and collecting expert opinion during an international consensus meeting with experts from relevant speciliaties. EVIDENCE REVIEWIn a consensus meeting conducted on April 4, 2018, a total of 47 questions covering preoperative, intraoperative, and postoperative care were formulated by 12 international experts with extensive clinical experience in the field of UA surgery for OSA. Systematic literature searches were performed by an independent information specialist and 6 researchers according to the Oxford and GRADE systems, and 164 articles published on or before December 31, 2011, were included in the analysis. Two moderators chaired the meeting according to the Amsterdam Delphi Method, including iteration of literature conclusions, expert discussion, and voting rounds. Consensus was reached when there was 70% or more agreement among experts.FINDINGS Of 47 questions, 35 led to a recommendation or statement. The remaining 12 questions provided no additional information and were excluded in the judgment of experts. Consensus was reached for 32 recommendations. For 1 question there was less than 70% agreement among experts; therefore, consensus was not achieved. Highlights of these recommendations include (1) postoperative bleeding is a complication described for all types of UA surgery; (2) OSA is a relative risk factor for difficult mask ventilation and intubation, and plans for difficult airway management should be considered and implemented; (3) safe perioperative care should be provided, with aspects such as OSA severity, adherent use of positive airway pressure, type of surgery, and comorbidities taken into account; (4) although there is no direct evidence to date, in patients undergoing UA surgery, preoperative treatment with positive airway pressure may reduce the risk of postoperative airway complications; and (5) alternative pain management options perioperatively to reduce opioid use should be considered.CONCLUSIONS AND RELEVANCE This consensus contains 35 recommendations and statements on the perioperative care of patients with OSA undergoing UA surgery and may be used as a guideline in daily practice.

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Analgesic properties of a dexmedetomidine infusion after uvulopalatopharyngoplasty in patients with obstructive sleep apnea

Cited by 34 publications

References 21 publications

The effectiveness of intravenous dexmedetomidine on perioperative hemodynamics, analgesic requirement, and side effects profile in patients undergoing laparoscopic surgery under general anesthesia

The effectiveness of intravenous dexmedetomidine on perioperative hemodynamics, analgesic requirement, and side effects profile in patients undergoing laparoscopic surgery under general anesthesia

Effect of intravenous vitamin C on postoperative pain in uvulopalatopharyngoplasty with tonsillectomy

Perioperative Care of Patients With Obstructive Sleep Apnea Undergoing Upper Airway Surgery

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