Intraoperative Dexmedetomidine Promotes Postoperative Analgesia in Patients After Abdominal Colectomy

Abstract

Surgery-induced acute postoperative pain may lead to prolonged convalescence. The present study was designed to investigate the effects of intraoperative dexmedetomidine on postoperative analgesia following abdominal colectomy surgeries. Eighty patients scheduled for abdominal colectomy surgery under general anesthesia were divided into 2 groups, which were maintained using propofol/remifentanil/dexmedetomidine (PRD) or propofol/remifentanil/saline (PRS). During surgery, patients in the PRD group had a lower bispectral index (BIS) value, which indicated a deeper anesthetic state, and a higher sedation score right after extubation than patients in the PRS group. During the first 24 hours post surgery, PRD patients consumed less morphine in patient-controlled analgesia (PCA) and had a lower score in the visual analog scale (VAS) testing than their controls from the PRS group. Intraoperative administration of dexmedetomidine appears to promote the analgesic property of morphine-based PCA in patients after abdominal colectomy.

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

“…[1] For example, recent clinical studies indicated that intraoperative administration of DEX shown potent proanalgesic effect on morphine-based PCA. [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] …”

“…The analgesic and opioid-sparing effects of DEX have been well described in previous studies both in adults and children. [6–8,11–13] Two recent meta-analyses reported results of reduced morphine consumption and significantly lower pain intensity in patients treated with DEX compared with placebo. [10,14] Consistently, in the present study, there was no difference between PRD w and PRD o groups with respect to the proanalgesic and morphine-sparing effect.…”

“…Ramsay sedation score was evaluated as previous reports. [6–8] Rescue morphine in the postanesthesia care unit (PACU) was included in the total consumption of postoperative PCA morphine. Postoperative acute pain intensity was evaluated with visual analog scale (VAS).…”

“…[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.…”