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2016 ; 7
(ä): 407
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gab.com Text
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English Wikipedia
The Opioid-Sparing Effect of Perioperative Dexmedetomidine Plus Sufentanil
Infusion during Neurosurgery: A Retrospective Study
#MMPMID27833559
Su S
; Ren C
; Zhang H
; Liu Z
; Zhang Z
Front Pharmacol
2016[]; 7
(ä): 407
PMID27833559
show ga
Background: Approximately 60% of patients experience moderate-to-severe pain
after neurosurgery, which primarily occurs in the first 24-72 h. Despite this,
improved postoperative analgesia solutions after neurosurgery have not yet been
devised. This retrospective study was conducted to evaluate the effect of intra-
and post-operative infusions of dexmedetomidine (DEX) plus sufentanil on the
quality of postoperative analgesia in patients undergoing neurosurgery. Methods:
One hundred and sixty-three post-neurosurgery patients were divided into two
groups: Group D (DEX infusion at 0.5 ?g·kg(-1) for 10 min, then adjusted to 0.3
?g·kg(-1)·h(-1) until incision suturing) and Group ND (no DEX infusion during
surgery). Patient-controlled analgesia was administered for 72 h after surgery
(Group D: sufentanil 0.02 ?g·kg(-1)·h(-1) plus DEX 0.02 ?g·kg(-1)·h(-1), Group
ND: sufentanil 0.02 ?g·kg(-1)·h(-1)) in this retrospective study. The primary
outcome measure was postoperative sufentanil consumption. Hemodynamics,
requirement of narcotic, and vasoactive drugs, recovery time and the incidence of
concerning adverse effects were recorded. Pain intensity [Visual Analogue Scale
(VAS)], Ramsay sedation scale (RSS) and Bruggemann comfort scale (BCS) were also
evaluated at 1, 4, 8, 12, 24, 48, and 72 h after surgery. Results: Postoperative
sufentanil consumption was significantly lower in Group D during the first 72 h
after surgery (P < 0.05). Compared with Group ND, heart rate (HR) in Group D was
significantly decreased from intubation to 20 min after arriving at post
anesthesia care unit (PACU), while mean arterial pressure (MAP) in Group D was
significantly decreased from intubation to 5 min after arriving at PACU (P <
0.05). The intraoperative requirements for sevoflurane, remifentanil, and
fentanyl were approximately 35% less in Group D compared with Group ND. VAS at
rest at 1, 4, and 8 h and with cough at 12, 24, 48, and 72 h after surgery were
significantly lower in Group D (P < 0.05). Compared with Group ND, patients in
Group D showed lower levels of overall incidence of tachycardia, hypertension,
nausea, and vomiting (P < 0.05). There were no significant differences between
the two groups in terms of baseline clinical characteristics, recovery time, RSS,
and BCS (P > 0.05). Conclusions: DEX (0.02 ?g·kg(-1)·h(-1)) plus sufentanil (0.02
?g·kg(-1)·h(-1)) could reduce postoperative opioid consumption and concerning
adverse adverse effects, while improving pain scores. However, it did not
influence RSS and BCS during the first 72 h after neurosurgery.