Cost analysis of dexmedetomidine versus propofol during the implantation of a neurostimulator

Bruggen, Feline F J A Ter; Stronks, Dirk L.; Huygen, Frank

doi:10.1111/aas.13579

Cited by 2 publications

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References 5 publications

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“…Nevertheless, the sedation costs represented less than 0.5% of the whole cost for the procedure, with the cost difference being significant but factually small. Use of DEX therefore added value for the patient (higher patient satisfaction, better awakening conditions) and was justified [ 39 ]. The cost-effectiveness of DEX in craniotomy patients should be a future health–economic research topic.…”

Section: Discussionmentioning

confidence: 99%

Effects of Intraoperative Dexmedetomidine Infusion on Postoperative Pain after Craniotomy: A Narrative Review

et al. 2021

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Craniotomy involves procedures with high incidences of postoperative pain. Dexmedetomidine, a highly selective a2-adrenoreceptor agonist, has been shown to be beneficial in neuroanaesthesia. The purpose of this narrative review was to assess the effect and safety of dexmedetomidine given intraoperatively during anaesthesia compared to placebo and demonstrate the effect on acute postoperative pain in adult patients undergoing craniotomy. Literature published from 1996 until 2021 were analysed through a search of PubMed, Medline and Embase. Randomised controlled trials investigating intraoperative administration of Dexmedetomidine with evaluation of postoperative pain were included. Medical Subject Headings terms and free-text words were used to identify articles related to the intraoperative use of Dexmedetomidine and postcraniotomy pain. Thirteen distinct randomized controlled trials with 882 recruited patients undergoing craniotomy were identified as eligible for final inclusion. Intraoperative administration of dexmedetomidine is associated with decreased postoperative pain and opioid consumption, and it assures haemodynamic stability. Dexmedetomidine is an efficacious adjunct in craniotomy in adults, showing benefits in reduction of postoperative pain and analgesic consumption. Dexmedetomidine also offers haemodynamic stability. However, widespread methodological heterogeneity of the papers prohibits a valid meta-analysis.

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Section: Discussionmentioning

confidence: 99%

Effects of Intraoperative Dexmedetomidine Infusion on Postoperative Pain after Craniotomy: A Narrative Review

et al. 2021

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“…It provides a smooth and rapid induction and easily controllable and stable continuation of sedation, and its cost is relatively low. 7 However, because propofol acts on the GABA receptors, difficulties may arise with regard to obtaining reliable feedback immediately after waking, due to the drowsiness of the patient.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysis

Bruggen

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Stronks

et al. 2021

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Objective: The success of neurostimulation depends partly on the amount of coverage of the neurostimulation-induced paresthesia of the painful area. This is often achieved by asking feedback from patients intraoperatively. If sedation analgesia is used, it is important that the patient is comfortable during sedation and easily arousable. If the patient is not well sedated or experiences residual effects of the sedation during testing, this can directly influence the ideal placement of the leads and indirectly the long-term effect of the treatment. It is our hypothesis that the quality of the sedation is directly coupled to the adequacy of lead placement and in this way in the result of the treatment. Dexmedetomidine is known for its easy production of arousable sedation. The aim of the present study was to compare the long-term effect of using dexmedetomidine versus propofol during the implantation of a neurostimulator. Materials and Methods: This is a post-trial follow-up analysis of the DexMedPro cohort. The primary outcome was global perceived effect (GPE). The secondary outcomes were the course of pain intensity, the emotional and physical functioning at the time of follow-up, and the course of neurostimulation treatment. In this study, we used the patient satisfaction with sedation as a measure for sedation quality. Results: Regarding the GPE, no statistically significant differences were found between the experimental groups in either subscale (ie, recovery (p=0.82) and satisfaction with the neurostimulation treatment at follow-up (p=0.06)). The same was found regarding the secondary parameters. A correlation was found between patient satisfaction with sedation during the lead implantation (side effects and procedural recall) and satisfaction at follow-up. Conclusion: Regarding the long-term efficacy of neurostimulation treatment, no statistically significant differences were found between the dexmedetomidine and the propofol group. We observed a trend towards greater satisfaction with the neurostimulation treatment at followup in the dexmedetomidine group, compared to the propofol group.

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Cost analysis of dexmedetomidine versus propofol during the implantation of a neurostimulator

Cited by 2 publications

References 5 publications

Effects of Intraoperative Dexmedetomidine Infusion on Postoperative Pain after Craniotomy: A Narrative Review

Effects of Intraoperative Dexmedetomidine Infusion on Postoperative Pain after Craniotomy: A Narrative Review

Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysis

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