Dexmedetomidine Decreases Postoperative Pain and Narcotic Use in Children Undergoing Alveolar Bone Graft Surgery.

Autor:	Lopez MM; 1 Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX, USA., Zech D; 2 Department of Oral and Maxillofacial Surgery, Health Science Center, University of Texas Houston, Houston, TX, USA., Linton JL; 3 Department of Plastic Surgery, Shriners Hospitals for Children-Houston, Houston, TX, USA., Blackwell SJ; 3 Department of Plastic Surgery, Shriners Hospitals for Children-Houston, Houston, TX, USA.; 4 Division of Plastic Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
Jazyk:	angličtina
Zdroj:	The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association [Cleft Palate Craniofac J] 2018 May; Vol. 55 (5), pp. 688-691. Date of Electronic Publication: 2018 Feb 15.
DOI:	10.1177/1055665618754949
Abstrakt:	Objective: Dexmedetomidine is a parenteral agent that combines the benefits of cooperative sedation, anxiolysis, and analgesia without the risks of respiratory depression. Off-label use has been reported in children. We have introduced dexmedetomidine for use in patients having undergone alveolar bone graft (ABG). The objective is to demonstrate the value and safety of postoperative dexmedetomidine infusion in a non-ICU setting following ABG. Design: A retrospective review was performed on patients who underwent ABG by the senior author. Patients were divided into 2 groups: those who received postoperative dexmedetomidine and those who received patient-controlled anesthesia. Main Outcome Measure(s): The primary study outcome measures included patient demographics, adverse events, length of stay, pain scores, and doses of narcotics during admission were collected. Results: Inclusion criteria were met by 54 patients; 39 received dexmedetomidine whereas 15 did not. There were no significant differences between groups in age, gender, and length of stay. The patients who received dexmedetomidine used oral narcotics less often ( P = .01). In addition, more patients reported no pain after surgery ( P = .05) and at the time of discharge if they received dexmedetomidine ( P < .01). There were no reported adverse effects. Conclusions: Dexmedetomidine provided superior pain control after surgery and at the time of discharge, as well as a significant decrease in the use of oral narcotics. In our institution, it has since replaced the PCA as a postoperative pain control modality. Absent the risk for respiratory depression, dexmedetomidine has demonstrated a safe option for postoperative pain control in our focused group of pediatric patients.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu