Dexmedetomidine as sedative and analgesic in a patient of sickle cell disease for total hip replacement

Dhansura, Tasneem; Kapadia, Shakir; Gandhi, Shweta

doi:10.4103/0019-5049.118521

Cited by 3 publications

(7 citation statements)

References 5 publications

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“…It has been reported that preoperative intravenous DEX can prevent tourniquet-induced hypertension in orthopedic operations [30]. In a case report, it was reported that DEX was effective as a sedative and analgesic for a total hip replacement patient [31]. In a recent research, Mei et al reported that the intraoperative sedation of DEX was better than propofol in THA for elder patients [32].…”

Section: Discussionmentioning

confidence: 99%

Combination of post-fascia iliaca compartment block and dexmedetomidine in pain and inflammation control after total hip arthroplasty for elder patients: a randomized control study

Liu

et al. 2020

J Orthop Surg Res

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Objective: This study aims to investigate the efficiency of fascia iliaca compartment block (FICB) combined with dexmedetomidine (DEX) in postoperative and inflammation management for elder patients after total hip arthroplasty. Methods: The present randomized controlled study included a total of 119 elder patients who received total hip arthroplasty in our hospital from March 2016 to December 2018. These patients were divided into three groups: control group, patients received routine general anesthesia; FICB group, patients received additional FICB after surgery; and combined group, patients received both pre-treatment of DEX and post-treatment of fascia iliaca compartment block. The serum levels of interleukin (IL)-1β, IL-6, and C-reactive protein (CRP) were measured by ELISA. The visual analog scale (VAS) score was measured at 12, 24, 48, and 72 h after surgery, and the patientcontrolled intravenous analgesia (PCIA) pressing time within 48 h after surgery was also recorded. The Pittsburgh sleep quality index (PSQI) was used to measure the sleep quality before and at 1 month after surgery. Results: The VAS scores were significantly lower in patients in the combined group, when compared with the other two groups, at 12, 24, 48, and 72 h after surgery. In addition, the VAS scores at all time points were significantly lower in the FICB group than the control group. The PCIA pressing times were also remarkably lower in the combined group. At 4, 24, 48, and 72 h after surgery, the serum levels of these inflammatory factors were the lowest in the combined group, and the PSQI scores were significantly lower in the combined group, when compared with the other two groups, while the control group had the highest PSQI scores among the three groups. There was no severe side effects and significant difference observed. Conclusion: FICB combined with DEX reduced the postoperative pain, improved the sleep condition, and decreased the serum levels of inflammatory factors after total hip arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Combination of post-fascia iliaca compartment block and dexmedetomidine in pain and inflammation control after total hip arthroplasty for elder patients: a randomized control study

Liu

et al. 2020

J Orthop Surg Res

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“…There are a few reports of the use of dexmedetomidine in adults with SCD 17,18 . In one report, two patients presenting to the emergency room with VOE were treated with a bolus dose and a continuous infusion of dexmedetomidine for a total of four hours.…”

Section: Discussionmentioning

confidence: 99%

“…Those patients were discharged pain-free and off opioids 17 . In another report, an adult SCD patient undergoing total hip replacement received dexmedetomidine infusion as an adjuvant for intra-and post-operative analgesia along with a continuous epidural infusion of local anesthetics 18 . In those reports, dexmedetomidine was tolerated and decreased opioid requirements.…”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine decreases opioid consumption and pain intensity 12,14 , and in settings where patients are on high-dose opioids, dexmedetomidine halts escalation of opioid intake and facilitates opioid weaning 15,16 . There are a few reported cases of dexmedetomidine use in SCD patients in emergency rooms and during the perioperative period 17,18 . Therefore, given its favorable therapeutic index and the salutary effects in decreasing opioid requirement, one might argue that dexmedetomidine might have a role in SCD pain.…”

Section: Introductionmentioning

confidence: 99%

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(463) Dexmedetomidine as an adjuvant to analgesic strategy during vaso-occlusive episodes in adolescents with sickle cell disease

Sheehy¹,

Finkel²,

Darbari³

et al. 2015

The Journal of Pain

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“…Dexmedetomidine decreases opioid consumption and pain intensity, and in settings where patients are on high‐dose opioids, dexmedetomidine halts escalation of opioid intake and facilitates opioid weaning . There are a few reported cases of dexmedetomidine use in patients with SCD in emergency rooms and during the perioperative period . Therefore, given its favorable therapeutic index and the salutary effects in decreasing opioid requirement, one might argue that dexmedetomidine might have a role in SCD pain.…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine as an Adjuvant to Analgesic Strategy During Vaso‐Occlusive Episodes in Adolescents with Sickle‐Cell Disease

et al. 2015

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Patients with sickle cell disease (SCD) can experience recurrent vaso-occlusive episodes (VOE), which are associated with severe pain. While opioids are the mainstay of analgesic therapy, in some SCD patients, increasing opioid use is associated with continued and increasing pain. Dexmedetomidine, a α2-adrenoreceptor agonist with sedative and analgesic properties, has been increasingly used in the perioperative and intensive care settings and has been shown to reduce opioid requirement and to facilitate opioid weaning. Therefore, there might be a role for dexmedetomidine in pain management during VOEs in SCD patients. Here we present the hospital course of three patients who during the course of VOEs had severe pain unresponsive to opioids and ketamine and were treated with dexmedetomidine. Dexmedetomidine infusions that lasted for three to six days were associated with marked reduction in daily oral morphine-equivalent intake and decreases in pain scores (numeric rating scale). There were no hemodynamic changes that required treatment with vasoactive or anticholinergic agents. These preliminary findings of possible beneficial effects of dexmedetomidine in decreasing opioid requirements support the hypothesis that dexmedetomidine may have a role as a possible analgesic adjuvant to mitigate VOE-associated pain in patients with SCD.

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Dexmedetomidine as sedative and analgesic in a patient of sickle cell disease for total hip replacement

Cited by 3 publications

References 5 publications

Combination of post-fascia iliaca compartment block and dexmedetomidine in pain and inflammation control after total hip arthroplasty for elder patients: a randomized control study

Combination of post-fascia iliaca compartment block and dexmedetomidine in pain and inflammation control after total hip arthroplasty for elder patients: a randomized control study

(463) Dexmedetomidine as an adjuvant to analgesic strategy during vaso-occlusive episodes in adolescents with sickle cell disease

Dexmedetomidine as an Adjuvant to Analgesic Strategy During Vaso‐Occlusive Episodes in Adolescents with Sickle‐Cell Disease

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