The Effect of Epidural Infusion of Dexmedetomidine on Postoperative Analgesia After Thoracotomy: A Randomized Clinical Trial.

Autor:	Entezary SR; School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.; Anesthesiology and Pain Fellowship, Rasoul Akram Medical Center, Tehran, Iran., Faiz SHR; Minimally Invasive Surgery Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran., Alebouyeh MR; School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.; Anesthesiology and Pain Fellowship, Rasoul Akram Medical Center, Tehran, Iran., Sharifian A; Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran., Derakhshan P; Pain Research Center, Department of Anesthesiology and Pain Medicine, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Jazyk:	angličtina
Zdroj:	Anesthesiology and pain medicine [Anesth Pain Med] 2023 Mar 05; Vol. 13 (1), pp. e134842. Date of Electronic Publication: 2023 Mar 05 (Print Publication: 2023).
DOI:	10.5812/aapm-134842
Abstrakt:	Background: The unique analgesic properties of dexmedetomidine have led anesthesiologists to use it as an alternative to relieve pain after major surgeries. Objectives: We aimed to evaluate the effect of continuous injection of thoracic epidural dexmedetomidine on analgesia after thoracotomy. Methods: In this randomized, double-blind clinical trial, 46 patients (18 to 70 years old) who were candidates for thoracotomy surgery were randomly assigned to receive ropivacaine alone or combined with dexmedetomidine after epidural anesthesia as postoperative epidural anesthesia. The postoperative sedation rate, pain score, and opioid use were assessed within 48 hours after surgery and compared between the 2 groups. Results: Comparing the mean postoperative sedation scores indicated no difference between the 2 study groups. The pain score assessment showed a lower pain score 6 to 36 hours after surgery in the group receiving concurrent ropivacaine and dexmedetomidine than in the group receiving ropivacaine alone. In the 2 groups receiving ropivacaine with and without dexmedetomidine, the rate of morphine administration after surgery was 43.4% and 65.2%, respectively, indicating no difference. However, the first group received significantly lower doses of morphine after the end of surgery (3.26 ± 0.90 mg vs. 7.04 ± 1.48 mg; P = 0.035). Conclusions: A combination of ropivacaine and dexmedetomidine as epidural analgesia can lead to lower postoperative pain scores and reduced doses of opioids required. Competing Interests: Conflict of Interests: Seyed Hamid Reza Faiz, Pooya Derakhshan and Mahmood Reza Alebuyeh are reviewers for this journal. Mahmood Reza Alebuyeh is also one of the editorial board members. (Copyright © 2023, Author(s).)
Databáze:	MEDLINE
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