Adjunctive dexmedetomidine infusion in open living donor hepatectomy: A way to enhance postoperative analgesia and recovery

Abstract

Open living donor hepatectomy (OLDH) is an intensely painful procedure, with moderate-to-severe pain during the first 2 days after surgery; furthermore, 31% and 27% of donors have developed persistent pain by 6 and 12 months after OLDH, respectively. 1 Inadequate control of perioperative pain will affect the overall quality of life and may contribute to chronic pain. Therefore, advanced strategies should be used to enhance perioperative analgesia and postoperative recovery in patients undergoing OLDH.Enhanced recovery after surgery (ERAS) is an evidence-based, multidisciplinary, and multimodal approach to patient care during the perioperative period. The ERAS pathways seek to blunt surgical stress and maintain endocrine and metabolic homeostasis, thereby

[Retracted] Effect of Dexmedetomidine Combined with Ropivacaine on Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Craniocerebral Surgery

“…Craniocerebral surgery is required for brain tumors, severe brain trauma, cranial deformation, encephalorrhagia, and other diseases, which is a common brain surgery, but with a high risk due to the special surgical sites [ 13 – 15 ]. Before surgery, patients should be routinely examined to select the appropriate anesthesia and surgical methods, mainly including the detection of the cerebral metabolism, intracranial pressure, and cerebral blood flow.…”

Does multimodal perioperative pain management enhance immediate and short‐term outcomes after living donor partial hepatectomy? A systematic review of the literature and expert panel recommendations

“…There were no reported technical difficulties or complications of regional or neuroaxial techniques in these cohorts. Adjuvant pharmacological therapies investigated were: Dexmedetomidine, a potent alpha‐2 agonist with hypnotic, sedative, and analgesic properties; ketamine, a NMDA receptor antagonist with sedating, analgesic, and hypnotic actions; intravenous lidocaine, a sodium channel blocker with analgesic properties; ketorolac, a non‐steroidal anti‐inflammatory drug; and parecoxib, a cyclo‐oxygenase‐2 inhibitor 9,11–15 . A single feasibility study investigated the role of acupuncture in this setting and concluded that the delivery of acupuncture was possible in this cohort of patients 8 .…”

“…Post‐operative pain scores were reported in eight studies (Table 2 and Supplementary Table S1). Four out of five studies included a control group and showed a significantly lower pain score at 24 h 9,11–13 . The multi‐modal approach by Hardman et al.…”

“…Post-operative pain scores were reported in eight studies (Table 2 and Supplementary Table S1). Four out of five studies included a control group and showed a significantly lower pain score at 24 h. 9,[11][12][13] The multi-modal approach by Hardman et al did not report a significant difference in pain scores when compared to controls. 14 The study by Kang et al showed a significantly higher pain score at 24 h with ESB when compared to intrathecal morphine, but this was not apparent at 48 or 72 h. There was no significant difference in pain scores in a comparison of ketorolac v. parecoxib.…”

Dexmedetomidine Combined with Femoral Nerve Block Provides Effective Analgesia Similar to Femoral Nerve Combined with Sciatic Nerve Block in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Study

“…It has also been reported that systemic DEX could prolong the duration of analgesia. 23,24 Additional sciatic nerve block could prolong the duration of analgesia for relieving postoperative pain. In our study, the duration of analgesia between the two groups was similar.…”