Effect of dexmedetomidine on recovery profile of patients undergoing anterior cervical discectomy and fusion

Jain, Veena; Chaturvedi, Arvind; Pandia, Mihir Prakash; Bithal, Parmod K.

doi:10.4103/joacp.joacp_5_18

Cited by 6 publications

(3 citation statements)

References 27 publications

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“… 11 , 16 , 27 , 28 , 29 Although it takes longer to achieve stable sedation with dexmedetomidine than with propofol or remifentanil, dexmedetomidine produces sedation with minimal respiratory depression and stable haemodynamics (blunted tachycardia and hypertensive responses to stimuli) in neurosurgical patients. 16 , 29 , 30 , 31 , 32 …”

mentioning

confidence: 99%

Dexmedetomidine depresses neuronal activity in the subthalamic nucleus during deep brain stimulation electrode implantation surgery

et al. 2022

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confidence: 99%

Dexmedetomidine depresses neuronal activity in the subthalamic nucleus during deep brain stimulation electrode implantation surgery

et al. 2022

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“…14 This prolongation in Group KD can be attributed to sedative effect of dexmedetomidine. In a study done by Xu et al, and another one done by Jain et al, they found prolonged extubation time when studying the effect of dexmedetomidine on recovery from GA. 15,16 Three patients in Group OP desaturated in PACU and they needed oxygen by applying a face mask and that did not occur in Group KD but this difference was statistically insignificant. A study done by Abdelrahman and Algharabawy.…”

Section: Discussionmentioning

confidence: 94%

Ketodex versus opioid based anesthesia in cleft palate

Mohamed,

Abdelraof,

Noser

2024

Anaesth. pain intensive care

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Background & objective: Cleft palate is a congenital anomaly of the palate of the infants, and it may or may not be associated with cleft lip. The only remedy is surgical repair under general anesthesia. Postoperative pain relief in cleft palate repair surgery is very important to keep the infant or child calm and pain-free. It can only be achieved by use of analgesic drugs. We compared ketodex - a combination of ketamine and dexmedetomidine, versus opioid based anesthesia in cleft palate surgery as regards postoperative respiratory depression, need for oxygenation, and the emergence agitation. Methodology: Fifty children, aged 6 months to 5 y, undergoing cleft palate surgery under general anesthesia, were randomly assigned to either ketodex group (Group KD) or opioids group (Group OP). Group KD received ketamine 1mg/kg loading dose followed by infusion @ 0.1 mg/kg/h, and dexmedetomidine loading dose 1 µg/kg followed by infusion @ 0.2 µg/kg/h], isoflurane anesthesia. Group OP received fentanyl in a loading dose of 2 µg/kg followed by infusion @ 0.5 µg/kg/h, followed by isoflurane anesthesia. Heart rate, mean blood pressure, emergence agitation, extubation time, FLACC score for pain, surgeons’ satisfaction, and the adverse effects were noted. Results: Emergence agitation score was significantly lower in Group KD compared to Group OP. FLACC score showed insignificant difference between the two groups. There was no need for opioid administration in the PACU. Three patients in Group OP desaturated and needed oxygen supply. Incidence of vomiting was significantly higher in Group OP compared to Group KD (P = 0.022). Conclusion: Ketodex used in opioid free anesthesia for cleft palate repair surgery in children provides adequate pain relief without respiratory depression, and is a good alternative of routine opioid based general anesthesia. Key words: Ketamine; Dexmedetomidine; Opioids; Anesthesia; Recovery; Cleft Palate Surgery; Pediatrics Citation: Mohamed MM, Abdelraof AF, Noser MA. Ketodex versus opioid based anesthesia in cleft palate. Anaesth. pain intensive care 2024;28(1):74-80; DOI: 10.35975/apic.v28i1.2239 Received: May 31, 2023; Reviewed: June 06, 2023; Accepted: January 02, 2024

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“…Complications of dexmedetomidine with an approximate prevalence of 10% usually include cardiovascular complications, CNS complications, and gastrointestinal complications, the occurrence of which depends on the dose, duration, and indications for its administration. [ 13 ]…”

Section: Introductionmentioning

confidence: 99%

The effect of two different dexmedetomidine doses on the prevention of nausea and vomiting in discectomy surgery under spinal anesthesia

et al. 2023

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Background: Considering the preventative effect of various medications on such complications after surgery, the present study evaluated the effect of two different dexmedetomidine doses on the prevention of nausea and vomiting in discectomy surgery. Materials and Methods: The present controlled, double-blind clinical trial was performed on 135 patients that were candidates for discectomy surgery under spinal anesthesia, which were randomly allocated into three groups. Two different dexmedetomidine doses of 0.2 and 0.5 mcg/kg/h were intravenously administered using an infusion pump for 10 min in the first (DEX-0.2 group) and second (DEX-0.5 group) groups, respectively, with the third placebo group being used as a control group. Hemodynamic parameters, the severity of nausea and vomiting, and the incidence of complications were evaluated and recorded up to 24 h after surgery. Results: The results of the present study revealed that, 20 min after the intervention, the severity of nausea and vomiting in the control group (with the mean of 1.95 ± 1.58) was significantly higher than that of the DEX-0.2 and DEX-0.5 groups with the means of 1.52 ± 1.11 and 1.27 ± 0.99, respectively ( P = 0.010). In addition, no significant difference was found between the two dexmedetomidine doses in terms of the severity of nausea and vomiting ( P > 0.05). Conclusion: According to the results of the present study, a low dose of dexmedetomidine may be a more preferable choice as a preventive drug in the incidence of nausea and vomiting in discectomy surgery due to its lower complications, further reduction of nausea and vomiting, and more desirable hemodynamic stability.

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Effect of dexmedetomidine on recovery profile of patients undergoing anterior cervical discectomy and fusion

Cited by 6 publications

References 27 publications

Dexmedetomidine depresses neuronal activity in the subthalamic nucleus during deep brain stimulation electrode implantation surgery

Dexmedetomidine depresses neuronal activity in the subthalamic nucleus during deep brain stimulation electrode implantation surgery

Ketodex versus opioid based anesthesia in cleft palate

The effect of two different dexmedetomidine doses on the prevention of nausea and vomiting in discectomy surgery under spinal anesthesia

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