Effect of Continuous Paravertebral Dexmedetomidine Administration on Intraoperative Anesthetic Drug Requirement and Post-Thoracotomy Pain Syndrome After Thoracotomy: A Randomized Controlled Trial

Dutta, Vikas; Kumar, Bhupesh; Jayant, Aveek; Mishra, Anand Kumar

doi:10.1053/j.jvca.2016.05.045

Cited by 29 publications

(33 citation statements)

References 24 publications

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“…They also reported that FEV1 is significantly higher and rescue analgesia is significantly lower in paravertebral morphine group as compared with the systemic opioid group while no significant differences between the paravertebral bupivacaine group and systemic opioid group [31].…”

Section: Discussionmentioning

confidence: 93%

Intravenous versus Ultrasound Guided Thoracic Paravertebral Morphine-Dexmedetomidine Combination in Patients with Multiple Rib Fractures

Mogahed¹,

Salama²,

Elkahwagy³

2017

J Anesth Clin Res

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Section: Discussionmentioning

confidence: 93%

Intravenous versus Ultrasound Guided Thoracic Paravertebral Morphine-Dexmedetomidine Combination in Patients with Multiple Rib Fractures

Mogahed¹,

Salama²,

Elkahwagy³

2017

J Anesth Clin Res

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“…Among the 12 RCTs, the VAS was the most frequently used scale to determine the intensity of POP. Eight studies used the VAS [14,15,18,20,21,23-25] , three used the NRS [16,17,19] and one of them used the VRS [22] .…”

Section: Resultsmentioning

confidence: 99%

“…Types of surgery were thoracic surgery (n=425) [14,15,17,19,20,22,24] and cardiac surgery (n=379) [16,18,21,23,25] . As depicted in Table 3, only eight studies including 466 subjects reported their surgeries as elective.…”

Section: Resultsmentioning

confidence: 99%

“…Only the outcomes pertinent to our review were described. The primary or secondary outcomes of included studies were sufentanil (SUF) consumption [14,17,19] , the mean of pain intensity [14,15,17-20,22,23] , the median of POP [21] , the number of patient controlled intravenous analgesia (PCIA) self-administer [14] , the number of opioid injection [14,20] , morphine consumption [15,21,23,25] , the number of intraoperative anesthetic drug requirements [15] , fentanyl consumption [18,24] , postoperative analgesic requirements [22] , need for additional epidural bupivacaine [24] , and the incidence of POP [16] . The pain was evaluated from one to 72 hours after the operation.…”

Section: Resultsmentioning

confidence: 99%

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The Effect of Dexmedetomidine on the Acute Pain After Cardiothoracic Surgeries: A Systematic Review

Hassani¹,

Kiabi²,

Sharifi³

2018

Braz J Cardiovasc Surg

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IntroductionAcute post-operative pain remains a troublesome complication of cardiothoracic surgeries. Several randomized controlled trials have examined the efficacy of dexmedetomidine as a single or as an adjuvant agent before, during and after surgery. However, no evidence-based conclusion has been reached regarding the advantages of dexmedetomidine over the other analgesics.ObjectiveTo review the effect of dexmedetomidine on acute post-thoracotomy/sternotomy pain.MethodsMedline, SCOPUS, Web of Science, and Cochrane databases were used to search for randomized controlled trials that investigated the analgesia effect of dexmedetomidine on post-thoracotomy/sternotomy pain in adults' patients. The outcomes were postoperative pain intensity or incidence, postoperative analgesia duration, and the number of postoperative analgesic requirements.ResultsFrom 1789 citations, 12 trials including 804 subjects met the inclusion criteria. Most studies showed that pain score was significantly lower in the dexmedetomidine group up to 24 hours after surgery. Two studies reported the significant lower postoperative analgesia requirements and one study reported the significant lower incidence of acute pain after surgery in dexmedetomidine group. Ten studies found that the total consumption of narcotics was significantly lower in the dexmedetomidine group. The most reported complications of dexmedetomidine were nausea/vomiting, bradycardia and hypotension.ConclusionDexmedetomidine can be used as a safe and efficient analgesic agent for reducing the postoperative pain and analgesic requirements up to 24 hours after cardiothoracic surgeries. However, further well-designed trials are needed to find the optimal dosage, route, time, and duration of dexmedetomidine administration.

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“…Graduated epidural needle was inserted perpendicularly to the skin (1 to 2 cm lateral to the spinal process at the level of second lumbar vertebra) and when the needle reached the transverse process it was withdrawn to the subcutaneous tissue and redirected to walk off the caudal edge of the transverse process. When the needle reached the paravertebral space (which was identified by loss of resistance to air) and after negative (aspiration to be sure it is not intravascular) a bolus of 0.5 ml/kg of bupivacaine (0.25%) [13] and dexmetomidine 1 mic/kg [14] were injected.…”

Section: Methodsmentioning

confidence: 99%

Paravertebral Block vs. Caudal Block Using Dexmedetomidine Plus Local Anesthetics for Inguinal Hernia Repair in Pediatrics: A Randomized Prospective Trial

Khalil¹,

Marouf²

2017

J Anesth Clin Res

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Aim: We aimed to compare the effects of caudal block (CB) and paravertebral block (PVB) using dexmedetomidine plus local anesthetics on postoperative pain and analgesia requirements in pediatrics after inguinal hernia surgery.Methods: This randomized prospective study was carried out on 80 pediatric patients underwent inguinal hernia repair. Two groups (each 40 patients) were included in the study: group CB and group PVB. After a standardized general anaesthesia, caudal or lumbar paravertebral block was performed using bupivacaine (0.25%) and dexemetomidine 1 μg/kg . We recorded FLACC score, number of patients needed rescue analgesia, the total number of doses of rescue analgesia, the duration of postoperative analgesia, parents satisfaction and adverse events.Results: FLACC score was higher in group (CB) compared with group (PVB) at 12 h and 16 h postoperative. The total number of patients need postoperative analgesia and the total number of doses of postoperative analgesia were higher in group (CB) compared with group (PVB). The duration of postoperative analgesia was significantly longer in group (PVB) than group (CB) (16.25 ± 1.66 vs. 10.69 ± 1.34). Parent satisfaction was higher in group (PVB) than group (CB). No major complications were detected in both groups.Conclusion: paravertebral block (using dexmedetomidine+local anaesthetics) was associated with better postoperative analgesia and higher parents satisfaction compared to caudal block (using dexmedetomidine+local anaesthetics) for inguinal hernia repair in children.

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Effect of Continuous Paravertebral Dexmedetomidine Administration on Intraoperative Anesthetic Drug Requirement and Post-Thoracotomy Pain Syndrome After Thoracotomy: A Randomized Controlled Trial

Cited by 29 publications

References 24 publications

Intravenous versus Ultrasound Guided Thoracic Paravertebral Morphine-Dexmedetomidine Combination in Patients with Multiple Rib Fractures

Intravenous versus Ultrasound Guided Thoracic Paravertebral Morphine-Dexmedetomidine Combination in Patients with Multiple Rib Fractures

The Effect of Dexmedetomidine on the Acute Pain After Cardiothoracic Surgeries: A Systematic Review

Paravertebral Block vs. Caudal Block Using Dexmedetomidine Plus Local Anesthetics for Inguinal Hernia Repair in Pediatrics: A Randomized Prospective Trial

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