Effect of Dexmedetomidine combined with sufentanil for post- thoracotomy intravenous analgesia:a randomized, controlled clinical study

Abstract

BackgroundFew studies have investigated the use of dexmedetomidine in patient-controlled intravenous analgesia (PCIA) after thoracic surgery. This study to evaluate the effect of dexmedetomidine combined with sufentanil for PCIA after thoracotomy under general anaesthesia.MethodsNinety-seven adults patients scheduled for thoracotomy surgery. All two groups received PCIA with either sufentanil alone (control group) or combining dexmedetomidine with sufentanil (dexmedetomidine group). Hemodynamic measurements, visual analog scale (VAS) scores at rest and at coughing, Ramsay sedation score (RSS), analgesic consumption, and postoperative nausea and vomiting (PONV) as well as drug-related adverse effects were compared at 2, 6, 12, 24, 36 and 48 h postoperatively.ResultsIn the patients of the dexmedetomidine group, compared to the control group, the pain scores at rest or at coughing during 48 h postoperatively were lower (P < 0.001), the sedation scores were lower, the consumption of sufentanil and rescue meperidine were lower, and the number of episode of moderate PONV was three times lower. No signs of toxicity or local complications were observed. There was a non-significant trend for a lower HR and BP in the dexmedetomidine group vs. Control.ConclusionThe combining dexmedetomidine with sufentanil for post-thoracotomy PCIA can improve pain control together with the decrease in sufentanil requirements, and improve postoperative patient’s satisfaction compared with sufentanil alone in PCIA.Trial RegistrationThis trial was retrospectively registered on 27 April 2016 at the Chinese Clinical Trial Register (number: ChiCTR-ONC-16008376).

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

“…PONV are common complications for patients who received opioids. Many researches have agreed that DEX could reduce the incidence and severity of PONV in different surgery . Although our meta‐analysis found that the incidence of PONV was decreased in group DEX in our study, there was no significant difference between the anaesthetic‐with‐DEX and the without‐DEX groups.…”

Ultrasound Guided Continuous Quadratus Lumborum Block Hastened Recovery in Patients Undergoing Open Liver Resection: A Randomized Controlled, Open-label Trial

“…In PCIA group, the median number of pain score on coughing was 5 in the first day of post-operation ( Table 5) which suggested that about half patients may not receive adequate analgesia in the early postoperative period. Since the dose of sufentanil in this group is 0.05µg•kg-1•h-1, which was considered high in most clinical practices [22,23], increasing the dose of sufentanil may raise risk of side effects.…”

Prospective investigation of intravenous patient-controlled analgesia with hydromorphone or sufentanil: impact on mood, opioid adverse effects, and recovery

“…It was well demonstrated that hydromorphone has valuable advantages of rapid onset, robust analgesic efficacy, no ceiling effect for analgesia, inactive metabolite, and fewer side effects while compared to morphine [ 8 – 10 ]. Sufentanil, a highly selective mu opioid agonist, provides various advantages such as reliable analgesic efficacy, stable hemodynamics, and few side effects, and has been widely used as an postoperative analgesia in China [ 11 , 12 ]. Rapp et al reported that hydromorphone improved the mood of patients while compared to morphine [ 13 ].…”