Dexmedetomidine in Postoperative Analgesia in Patients Undergoing Hysterectomy

Abstract

Both dexmedetomidine and sufentanil modulate spinal analgesia by different mechanisms, and yet no human studies are available on their combination for analgesia during the first 72 hours after abdominal hysterectomy.This CONSORT-prospective, randomized, double-blinded, controlled trial sought to evaluate the safety and efficacy of the combination of dexmedetomidine and sufentanil in intravenous patient-controlled analgesia (PCA) for 72 hours after abdominal hysterectomy.Ninety women undergoing total abdominal hysterectomy were divided into 3 equal groups that received sufentanil (Group C; 0.02 μg/kg/h), sufentanil plus dexmedetomidine (Group D1; 0.02 μg/kg/h, each), or sufentanil (0.02 μg/kg/h) plus dexmedetomidine (0.05 μg/kg/h) (Group D2) for 72 hours after surgery in this double-blinded, randomized study. The primary outcome measure was the postoperative sufentanil consumption, whereas the secondary outcome measures were pain intensity (visual analogue scale), requirement of narcotic drugs during the operation, level of sedation, Bruggrmann comfort scale, and concerning adverse effects.The postoperative sufentanil consumption was significantly lower in Groups D1 and D2 than in Group C during the observation period (P < 0.05), but lower in Group D2 than in Group D1 at 24, 48, and 72 hours after surgery (P < 0.05). The heart rate after intubation and incision was lower in Groups D1 and D2 than in Group C (P < 0.05). On arrival at the recovery room, Groups D1 and D2 had lower mean blood pressure than Group C (P < 0.05). The intraoperative requirement of sevoflurane was 30% lesser in Groups D1 and D2 than in Group C. The sedation levels were greater in Groups D1 and D2 during the first hour (P < 0.05). Compared with Groups C and D1, Group D2 showed lower levels of the overall incidence of nausea and vomiting (P < 0.05).Among the tested PCA options, the addition of dexmedetomidine (0.05 μg/kg/h) and sufentanil (0.02 μg/kg/h) showed better analgesic effect and greater patient satisfaction without other clinically relevant side effects for patients undergoing hysterectomy during the first 72 hours after abdominal hysterectomy.

The Opioid-Sparing Effect of Perioperative Dexmedetomidine Plus Sufentanil Infusion during Neurosurgery: A Retrospective Study

“…A multimodal analgesia that could enhance analgesia and reduce the requirement for opioids would be productive. Previous studies conducted by this research group have found that the use of DEX-sufentanil for 72 h after surgery could offer better analgesic effects and patient satisfaction compared with sufentanil alone (Ren et al, 2015a,b). In this study, the dosage of sufentanil was significantly lower in Group D compared with Group ND from 4 to 72 h after surgery ( P < 0.05).…”

Effects of intraoperative dexmedetomidine with intravenous anesthesia on postoperative emergence agitation/delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy

“…Dexmedetomidine (DEX), with its potent and specific affinity of α 2 -adrenergic receptors, [10] has properties of sedation, antianxiety, and analgesic effects, [11–15] and can reduce the incidence of POED in pediatric patients undergoing inhalation anesthesia. [11,12,14,16–18] However, the impact of DEX on the incidence of POED in pediatric patients after intravenous anesthesia is unknown. In the present study, we observed the safety of intraoperative combination of DEX with intravenous anesthesia in pediatric patients undergoing tonsillectomy with or without adenoidectomy, and validity for the prevention of POED.…”

Comparison of the morphine-sparing effect of intraoperative dexmedetomidine with and without loading dose following general anesthesia in multiple-fracture patients

“…[6–8] A recent study reported that a combination of DEX and sufentani as PCA displayed a significantly improved analgesic effect in patients following hysterectomy. [4] …”

“…[4–9] Accumulating recent evidence is showing that intraoperative DEX with or without a loading dose both reduced morphine consumption, also called morphine-sparing effect, in PCA following general anesthesia. [4–8] A loading dose is normally administrated within a very short time period, for example, 5 to 10 minutes, which will result in more hemodynamics alterations, such as decrease of blood pressure and heart rate and intraoperative bradycardia. [10] However, the contribution of the loading dose to the proanalgesic effect of morphine-based PCA was largely unknown.…”