Dexmedetomidine as a Primary Systemic Analgesic for Craniotomy in an Obese Patient with Obstructive Sleep Apnea

Syeda, Seham; Palaniswamy, Sangeetha R; Sriganesh, Kamath

doi:10.4103/0028-3886.280650

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…These findings have been seen in the previous surgical literature; however, it has not been explored previously in a neurosurgical context. 1,10,22,23 In 2020, King and Liu 24 described racial disparities in opioid receipt for the treatment of back pain in the outpatient setting with White patients being more likely to receive opioid medications than Asian and Hispanic patients. Interestingly, in contrast to our study, Black patients were more likely to receive opioids for back pain treatment when compared with White patients.…”

Section: Discussionmentioning

confidence: 99%

“…In neurosurgery specifically, studies evaluating opioid prescribing practices have been conducted in limited postoperative neurosurgical conditions such as brain tumors, spinal pathologies, and trigeminal neuralgia; however, these have been relatively limited in scope. [7][8][9][10] The role of race and ethnicity has not yet been explored in the context of pain management for postoperative neurosurgical patients. Therefore, this study aims to investigate and characterize the perioperative opioid requirements and physician opioid prescribing practices across racial groups after neurological surgery.…”

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confidence: 99%

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Racial Differences in Postoperative Opioid Prescribing Practices in Spine Surgical Patients

Letchuman

Mummaneni

et al. 2022

Neurosurgery

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BACKGROUND:As the opioid epidemic accelerates in the United States, numerous sociodemographic factors have been implicated its development and are, furthermore, a driving factor of the disparities in postoperative pain management. Recent studies have suggested potential associations between the influence of race and ethnicity on pain perception but also the presence of unconscious biases in the treatment of pain in minority patients.OBJECTIVE:To characterize the perioperative opioid requirements across racial groups after spine surgery.METHODS:A retrospective, observational study of 1944 opioid-naive adult patients undergoing a neurosurgical spine procedure, from June 2012 to December 2019, was performed at a large, quaternary care institute. Postoperative inpatient and outpatient opioid usage was measured by oral morphine equivalents, across various racial groups.RESULTS:Case characteristics were similar between racial groups. In the postoperative period, White patients had shorter lengths of stay compared with Black and Asian patients (P < .05). Asian patients used lower postoperative inpatient opioid doses in comparison with White patients (P < .001). White patients were discharged with significantly higher doses of opioids compared with Black patients (P < .01); however, they were less likely to be readmitted within 30 days of discharge (P < .01).CONCLUSION:In a large cohort of opioid-naive postoperative neurosurgical patients, this study demonstrates higher inpatient and outpatient postoperative opioid usage among White patients. Increasing physician awareness to the effect of race on inpatient and outpatient pain management would allow for a modified opioid prescribing practice that ensures limited yet effective opioid dosages void of implicit biases.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Racial Differences in Postoperative Opioid Prescribing Practices in Spine Surgical Patients

Letchuman

Mummaneni

et al. 2022

Neurosurgery

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“…The initial exploration of relevant literature identified 1546 records. Through a stringent process of evaluation and selection, this number was distilled to seven critical studies [9][10][11][12][13][14][15] that met our predefined criteria, as depicted in Figure 1. These studies, which varied in design and demographic focus, are comprehensively outlined in Table 1.…”

Section: Resultsmentioning

confidence: 99%

The effect of dexmedetomidine on postoperative wound healing in neurosurgical patients: A meta‐analysis

Zhu,

Cao,

Chen

et al. 2023

International Wound Journal

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This meta‐analysis investigates the effect of dexmedetomidine on postoperative wound healing in neurosurgical patients. A thorough literature search resulted in the selection of seven studies from an initial pool of 1546 records. The analysis focused on wound healing outcomes, evaluated by the Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale and the Manchester Scar Scale (MSS). Results indicated significant improvements in the dexmedetomidine group: the REEDA scale scores at day seven post‐surgery showed a Standardized Mean Difference group (SMD = −16.18, 95% CI: [−22.30, −10.06], p < 0.01), and the MSS scores at 3 months post‐operation demonstrated an (SMD = −8.95, 95% CI: [−14.27, −3.62], p < 0.01). These findings suggest that dexmedetomidine may enhance wound healing and reduce scar formation in neurosurgical patients. Bias assessment indicated a low risk of bias across the studies.

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Episodes of Sudden and Transient Drops of Bi-Spectral Index during the Maintenance Phase of Neuroanesthesia

2022

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Dexmedetomidine as a Primary Systemic Analgesic for Craniotomy in an Obese Patient with Obstructive Sleep Apnea

Cited by 4 publications

References 3 publications

Racial Differences in Postoperative Opioid Prescribing Practices in Spine Surgical Patients

Racial Differences in Postoperative Opioid Prescribing Practices in Spine Surgical Patients

The effect of dexmedetomidine on postoperative wound healing in neurosurgical patients: A meta‐analysis

Episodes of Sudden and Transient Drops of Bi-Spectral Index during the Maintenance Phase of Neuroanesthesia

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