KMID : 1155520170120010037
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Anesthesia and Pain Medicine 2017 Volume.12 No. 1 p.37 ~ p.41
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The effect of pre-anesthetic administration of dexmedetomidine on the consumption of opioids in postoperative gynecologic patients
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Lee Kang-Yoo
Lee Woo-Yong Kim Kye-Min Yoo Byung-Hoon Lee Sang-Seok Lim Yun-Hee Kim Mun-Cheol Yon Jun-Heum
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Abstract
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Background: This study was designed to assess whether pre-anesthetic administration of dexmedetomidine reduces the postoperative consumption of opioids, in patients receiving patient-controlled fentanyl after gynecological laparotomy.
Methods: This was a prospective, randomized, double-blind, controlled study. Ten minutes before induction of anesthesia, 36 patients scheduled for elective gynecological laparotomy were assigned to receive either normal saline (group N) or dexmedetomidine 1 ¥ìg/kg (group D). A patient-controlled analgesia (PCA) device was used to administer fentanyl for the postoperative 24 h period. Cumulative fentanyl consumption and pain score were assessed at postoperative 30 min, 6 h and 24 h. Patient¡¯s satisfaction for pain control and other side effects (nausea, sedation score) were recorded for all corresponding time points.
Results: There was no significant difference between the groups in cumulative fentanyl consumption (Group N: 11.1 ¡¾ 3.2 ¥ìg/kg, Group D 10.3 ¡¾ 2.9 ¥ìg/kg, P value: 0.706). The incidence of side-effects did not differ between the groups. Both groups showed similar blood pressure after anesthesia induction. However, 10 min after anesthesia induction, the heart rates in group D were significantly lower than group N (P = 0.0002).
Conclusions: In patients undergoing gynecological laparotomy, the pre-anesthetic administration of single loading dose dexmedetomidine (1 ¥ìg/kg) given 10 min before anesthesia induction did not reduce the PCA consumption of postoperative fentanyl or the pain score.
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KEYWORD
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Adrenergic alpha-2 receptor agonists, Dexmedetomidine, Fentanyl, Patient-controlled analgesia, Postoperative pain
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