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KMID : 1040020140050010001
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International Journal of Pain
2014 Volume.5 No. 1 p.1 ~ p.10
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Effect of Perioperative Dexmedetomidine on Intraoperative Hemodynamic Response and Postoperative Fentanyl Requirement with Undergoing Robot Assisted Thyroid Surgery: A Randomized Controlled Trial
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Sung Joon-Kyung
Yoo Eun-Kyung
Kim Yong-Chul
Choi Seung-Pyo
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Abstract
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Background: The aim of this study was to evaluate the effect of perioperative use of dexmedetomidine on maintenance of intraoperative hemodynamic stability and preemptive analgesic effect to postoperative pain during robot assisted endoscopic thyroidectomy.
Methods: Sixty patients undergoing robot assisted endoscopic thyroidectomy were randomly assigned to either the placebo group (group P) or the dexmedetomidine group (group D). In group D, dexmedetomidine (1 μg/kg) was loaded intravenously for 10 min before anesthesia induction and was continuously infused at 0.2 μg/kg/h until starting skin suture. The same volume of normal saline was administered in the same manner to group P. Heart rate (HR), systolic blood pressure (BP) and mean BP were recorded at following moments; 1 minute after intubation (T1), 1 minute after local epinephrine injection (T2), 1 minute after breast skin incision (T3), 1 minute after port insertion (T4), 1 minute after axillary skin incision (T5) and every 15 minutes during operation (T6-T16). Total amount of fentanyl administration and NRS were recorded during postoperative 1 hour and 24 hours.
Results: Systolic BP at T1, 5-16, mean BP at T1,2,6, 11-16, and HR at T2,3 7-16 were significantly lower in group. Although there was no significant difference in pain score at postoperative 1 hour, it was higher at postoperative 24 hours in group D. Total amount of postoperative fentanyl administration had no significant difference.
Conclusions: Perioperative administration of dexmedetomidine significantly suppressed the cardiovascular responses to noxious stimuli. However, we did not find any advantage in postoperative analgesia of dexmedetomidine.
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KEYWORD
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dexmedetomidine, fentanyl, hemodynamic, analgesia, thyroid
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