Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

Abstract

BackgroundDexmedetomidine as an adjunct with opioids has been confirmed to spare opioids usage and improve analgesia for postoperative pain treatment. Furthermore, dexmedetomidine can attenuate the airway reflex. The aim of this study is to assess the safety and efficacy of dexmedetomidine combined with sufentanil for postoperative analgesia after partial laryngectomy.MethodsA total of 60 adult male patients were recruited and randomly allocated to receive sufentanil 1.0 μg ml−1 (Group S) or sufentanil 1.0 μg ml−1 plus dexmedetomidine 4 μg ml−1 (Group SD) for postoperative analgesia. The IV patient controlled analgesia (PCA) device was programmed to deliver 1.5 ml per demand with a 10 min lockout interval and 1.5 ml per hour background infusion. Cumulative consumption of sufentanil and pain intensity during 24 hour (h) after surgery were recorded. Coughing episodes per day, sleep quality, hemodynamic and respiratory profiles were measured.ResultsCompared with Group S, patients in Group SD required less sufentanil during the 0–24 h postoperative period (p < 0.0001) and reported significant lower pain intensity from the second postoperative hour to the end of the study (P < 0.0001). Daily coughing episodes, sleep disturbance was lower and patients’ satisfaction was higher in Group SD (P < 0.05). Decrease in heart rate and mean blood pressure from baseline at 1 h, 2 h, 3 h, 12 h, and 24 h after operation were significantly greater in Group SD (P = 0.00). The incidence of PCA related adverse events were comparable between the two groups.ConclusionDexmedetomidine/sufentanil combination for postoperatjve analgesia in partial laryngectomized patients resulted in significant sufentanil sparing, better analgesia, reduced frequency coughing episodes, and better sleep quality.Trial registrationChinese Clinical Registry (ChiCTR): ChiCTR-TRC-14004618, date of registration: 08 May 2014.

Combination of sufentanil, dexmedetomidine and ropivacaine to improve epidural labor analgesia effect: A randomized controlled trial

“…The combined use of ropivacaine, 0.25 µg/ml Dex and 0.25 µg/ml sufentanil displayed a quicker onset time, enhanced the analgesic effect, decreased the VAS scores, reduced the bolus frequency and limited motor blockage without causing adverse side effects compared with the use of either adjuvants alone. The results indicated that Dex synergized with sufentanil systemically and regionally, which was consistent with previously reported clinical results (26,30).…”

“…By contrast, certain studies have indicated that intrathecal Dex lengthens sensory and motor blockage during hysteroscopic surgery and cesarean sections (13,14), and the addition of epidural opioids results in a high inci-dence of respiratory depression, urinary retention, nausea, vomiting and pruritus (24,25). Qin et al (26) also reported that the combination of Dex and sufentanil for postoperative analgesia in patients with partial laryngectomy resulted in significantly reduced sufentanil consumption, improved analgesia, a reduced frequency of coughing episodes and improved sleep quality. To the best of our knowledge, the present study was the first study to investigate the combination of epidural Dex and sufentanil in labor analgesia.…”

Efficacy of dexmedetomidine in reducing post‑operative pain and improving the quality of recovery in patients with burn wounds undergoing tangential excision skin grafting

“…DEX is an α-2 adrenergic agonist that was developed in the 1990s and was first used as a short-term sedative in intensive care units (23). Clinical trials have confirmed that combining DEX with sufentanil for PCIA allows for a significant reduction in the amount of sufentanil administered and improves analgesia (24,25). Furthermore, similar results were obtained in a previous study for thoracic surgery where an infusion dose of 0.04 µg/kg/h DEX in combination with 0.02 µg/kg/h sufentanil reduced post-operative pain during the initial 72 h post-surgery (26).…”

State of the art opioid-sparing strategies for post-operative pain in adult surgical patients

“…Agonism of this alpha receptor induces multiple downstream effects including a decrease in sympathetic tone, attenuation of the neuroendocrine and hemodynamic response to surgery, reductions in anesthetic and opioid requirements, and induction of sedation and analgesia. There have been several studies assessing its benefit for postoperative analgesia when used during the perioperative period with mixed results [83][84][85][86][87][88][89][90][91][92][93][94][95][96]. However, many studies have demonstrated reduce postoperative opioid use when the drug is administered intraoperatively, specifically following laryngectomy [83], abdominal surgeries [84,95], bariatric surgery [91,96], cesarean section [86], off-pump coronary artery bypass surgery [87], knee surgery [88,94], tonsillectomy [90], and total abdominal hysterectomy [93].…”