Effect of dexmedetomidine as an adjuvant to ropivacaine for wound infiltration in patients undergoing open gastrectomy

Abstract

Objectives:The primary objective of this study was to investigate whether dexmedetomidine could potentiate the analgesic efficacy of ropivacaine, when added to ropivacaine for wound infiltration in patients undergoing open gastrectomy.Methods:Fifty patients scheduled for open gastrectomy were divided into 2 equal groups that were received wound infiltration using 20 mL 0.3% ropivacaine plus 2 mL normal saline (group R) or 20 mL 0.3% ropivacaine plus 2 mL 1.0 μg/kg dexmedetomidine (group DR). Visual analogue scale (VAS) pain score, patient-controlled analgesia (PCA) pump press number, sufentanil consumption, postoperative nausea and vomiting (PONV), and wound healing score were recorded.Results:The VAS pain score were comparable between the 2 groups at the observation time points (P > .05), PCA pump press number and sufentanil consumption were higher in group R than that in group DR at 0 to 2, 2 to 4, 4 to 6 time intervals (P < .05) except for 6 to 8, 8 to 10, 10 to 12 time intervals (P > .05), meanwhile, the 24 hours total sufentanil consumption was also higher in group R than that in group DR (90.4 ± 20.5 vs 79.2 ± 9.4) (P < .05), there were no significant differences in PONV and wound healing score between the 2 groups (P > .05).Conclusions:Dexmedetomidine as an adjuvant to ropivacaine for wound infiltration promoted the analgesic efficacy of ropivacaine, reduced sufentanil consumption, and had no effect on wound healing; it could be as an ideal adjuvant which could potentiate the analgesic efficacy of local anesthetics.

Efficacy of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in abdominal surgery: A meta‐analysis of randomised controlled trials

“…The search identified 251 studies, of which 198 were eliminated from further review because of not controlled trials or were duplications; after reviewing the abstracts, an additional 48 trials were excluded because they were not relevant to our study. Finally, the articles considered to be suitable for the meta‐analysis consisted of five RCTs, enrolling a total of 294 adult patients. The search process is shown in Figure .…”

“…Of the five studies, two studies were from India, two studies were from China, and one study was from Egypt. Four studies involved local wound infiltration at the end of the operation, and one study concerned local wound infiltration before the operation. Among them, local anaesthetics were ropivacaine in three studies, and bupivacaine in the other two studies .…”

“…Does DEX provide a similar effect on local wound infiltration in abdominal operation? At present, some clinical randomised controlled trials (RCTs) have studied this problem . Therefore, we wanted to see whether DEX could improve analgesia when used in combination with local anaesthetics for wound infiltration after abdominal surgery.…”

Effect of dexmedetomidine as an adjuvant to 0.25% bupivacaine for local infiltration of port site in laparoscopic cholecystectomy in terms of quality and duration of post-op analgesia

“…Wound infiltrative analgesia is a standard method of providing analgesia in surgical patients especially following laparoscopic cholecystectomy (6) . Previous studies have shown that dexmedetomidine is an effective adjuvant to bupivacaine in wound infiltrative analgesia following open surgeries (7,8) . Recent study has shown that dexmedetomidine is an effective adjuvant to ropivacaine following laparoscopic cholecystectomy (8) .…”

“…Previous studies have shown that dexmedetomidine is an effective adjuvant to bupivacaine in wound infiltrative analgesia following open surgeries (7,8) . Recent study has shown that dexmedetomidine is an effective adjuvant to ropivacaine following laparoscopic cholecystectomy (8) . This study also showed that dexmedetomidine when used as an adjuvant improves quality of analgesia as well as increases early ambulation with effective pain management.…”