Comparison of the effects of patient controlled analgesia (PCA) using dexmedetomidine and propofol during septoplasty operations: a randomized clinical trial

Abstract

IntroductionSeptoplastical surgery to correct septum deviation can be performed under either local or general anesthesia. During local anesthesia, sedation helps to provide minimum anxiety/discomfort. Our aim was to evaluate the effects of patient-controlled analgesia using dexmedetomidine and propofol on sedation level, analgesic requirement, and patient satisfaction.Study designA prospective, randomized-parallel clinical study.MethodsFifty patients undergoing septoplastical surgery at our university hospital were randomized into two groups. A nasopharyngeal cotton tampon soaked in 0.25 % adrenaline solution was placed, and 1 mg midazolam and 1 mcg/kg fentanyl were applied 5 min before the injections of a surgical local anesthetic. Loading dose was 0.5 mg/kg propofol (Group I) and 1 mcg/kg dexmedetomidine (Group II). The sedation was sustained by a bolus dose of 0.2 mg/kg and continuous basal infusion dose of 0.5 mg/kg/h propofol in Group I, or by a bolus dose of 0.05 µg/kg and continuous basal infusion dose of 0.4 mcg/kg/h dexmedetomidine in Group II. The primary outcomes were patient satisfaction via patient-controlled anesthesia and analgesic demand. Secondary outcomes were sedation level of patients under local anesthesia.ResultsIn Group II, SpO2 levels were significantly higher than in Group I. Intraoperative and postoperative analgesic requirements were lower in Group II than in Group I. There were no statistically significant differences in patient satisfaction, hemodynamic parameters, nausea and vomiting between the two groups.ConclusionDexmedetomidine can be used safely as an analgesic and sedation drug in septoplastic surgery.

Comparison of sedation with dexmedetomidine vs propofol during hysteroscopic surgery: Single-centre randomized controlled trial

“…Similar to our study, previous studies demonstrated that dexmedetomidine was associated with lower post-operative VAS score compared to the propofol. 8,10,16 We also showed that the post-operative Riker SAS score was significantly lower in the dexmedetomidine group compared to the propofol group. Based on these results, we can conclude that dexmedetomidine provides more advantages than propofol as a sedative agent during hysteroscopic surgery.…”

“…Wang et al showed that post‐operative pain score was significantly lower in the dexmedetomidine group compared to in the propofol group in patients undergoing inguinal hernia repair procedure. Akça et al found that dexmedetomidine provided more stable and satisfactory sedation than propofol in patients undergoing septoplastical surgery. Finally, Xu et al demonstrated that dexmedetomidine provided safer and more effective sedation than propofol in patients undergoing uvulopalatopharyngoplasty procedure.…”

“…In previous studies, it has been demonstrated that dexmedetomidine is a more beneficial sedative agent than propofol for conscious sedation during different ambulatory surgeries . However, there is no study comparing the effects of dexmedetomidine vs propofol in patients undergoing minor hysteroscopy surgeries.…”

“…In previous studies, it has been demonstrated that dexmedetomidine is a more beneficial sedative agent than propofol for conscious sedation during different ambulatory surgeries. [7][8][9][10][11] However, there is no study comparing the effects of dexmedetomidine vs propofol in patients undergoing minor hysteroscopy surgeries. The objective of this study was to compare the sedative, analgesic and hemodynamic effects of dexmedetomidine vs propofol in patients undergoing minor hysteroscopy surgery.…”

Efficacy of dexmedetomidine on perioperative morbidity during nasal surgery: A meta‐analysis

“…Outcomes analyzed were intra‐ and postoperative pain; postoperative (24 hours) analgesic requirements (dose of postoperative opioids or nonopioid analgesics); occurrence of postoperative nausea and vomiting (PONV) (incidence or percentage of patients); intraoperative hypotension; intraoperative bradycardia; intraoperative desaturation; occurrence of patient satisfaction (incidence or percentage of patients); and operative blood loss . In the enrolled study for analgesics, one study used diclofenac (nonsteroidal antiinflammatory drug) as the additional analgesic, and the remaining studies used opioids such as tramadol and fentanyl as the additional analgesics. In terms of bradycardia and hypotension, these states were defined as the hemodynamic instabilities to be treated with 0.5 mg of atropine injection or 5 mg of ephedrine injection individually, and were monitored at regular intervals during the operation.…”