Effect of Oxycodone Combined With Dexmedetomidine for Intravenous Patient-Controlled Analgesia After Video-Assisted Thoracoscopic Lobectomy

Wang, Xiuqin; Wang, Kaiguo; Wang, Baosheng; Jiang, Tao; Xu, Zan; Wang, Fumei; J, Yu

doi:10.1053/j.jvca.2016.03.127

Cited by 34 publications

(32 citation statements)

References 26 publications

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“…A prospective, randomized, double-blind, controlled trial reported that the combination of 50 mg oxycodone and 0.5 μg/kg/h dexmedetomidine for patient-controlled analgesia after video-assisted thoracoscopic lobectomy reduced oxycodone consumption, improved patient satisfaction, and provided better analgesia with fewer side effects (nausea and vomiting), compared with patient-controlled analgesia with oxycodone alone. 44 Another study adding 0.5 μg/kg dexmedetomidine and 1 μg/kg of neostigmine to 0.25% bupivacaine for epidural anesthesia in 20 patients undergoing orthopedic surgeries found synergism in the analgesic action and a decreased incidence of drug-related side effects. However, there was also an increased requirement of fluids to maintain blood pressure.…”

Section: Effect Of Postoperative Dexmedetomidine On Perioperative Paimentioning

confidence: 99%

Dexmedetomidine in perioperative acute pain management: a non-opioid adjuvant analgesic

Tang¹,

Xia²

2017

JPR

106

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Many nociceptive, inflammatory, and neuropathic pathways contribute to perioperative pain. Although opioids have long been a mainstay for perioperative analgesia, other non-opioid therapies, and dexmedetomidine, in particular, have been increasingly used as part of a multimodal analgesic regimen to provide improved pain control while minimizing opioid-related side effects. This article reviews the evidence supporting the preoperative, intraoperative, and postoperative efficacy of dexmedetomidine as an adjuvant, and the efficacy of intravenous, spinal canal, and nerve block analgesia with dexmedetomidine for perioperative acute pain treatment. While there have not been any large-scale clinical trials conducted, the current body of evidence suggests that dexmedetomidine is suitable for use as an adjuvant analgesic at all perioperative stages. However, there are potential adverse effects, such as hypotension and bradycardia, which must be taken into consideration by clinicians.

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Section: Effect Of Postoperative Dexmedetomidine On Perioperative Paimentioning

confidence: 99%

Dexmedetomidine in perioperative acute pain management: a non-opioid adjuvant analgesic

Tang¹,

Xia²

2017

JPR

106

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“…Among these pain management methods, epidural PCA and IV-PCA are considered to be the two main methods to manage pain after VATS (11,12). However, the use of epidural PCA remains controversial for patients receiving VATS because it has generally been reserved for those undergoing more painful procedures, like thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

Intramuscular stimulation as a novel alternative method of pain management after thoracic surgery

Moon¹,

Park²,

Kang³

et al. 2019

J. Thorac. Dis

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Background: The purpose of this study was to determine whether electrical twitch-obtaining intramuscular stimulation (ETOIMS) can be an alternative to intravenous patient-controlled analgesia (IV-PCA) for postoperative pain management in pneumothorax patients undergoing single-port video-assisted thoracoscopic surgery (VATS). Methods: This preliminary prospective randomized study was conducted between March 2017 and July 2017. A total of 26 patients undergoing single-port VATS were randomly assigned to two groups: the ETOIMS group (n=12), which received intramuscular stimulation prior to chest tube insertion toward the end of procedure, and the IV-PCA group (n=14), which received continuous infusion of fentanyl with a basal rate of 10 μg/mL/h. To measure postoperative pain, visual analogue scale (VAS; range, 0-10) was used as the primary endpoint. Results: Baseline characteristics were not different between the two groups. According to the linear mixed model, there was statistical difference in the serial VAS score between the two groups (P=0.007). The ETOIMS group showed a significantly lower VAS score compared with the IV-PCA group, especially at postoperatively hour 8, day 1, and day 2. Conclusions: We showed that ETOIMS may be a safe, effective, and simple alternative for pain management after single-port VATS.Moon et al. IMS after thoracic surgery (Medical Illustrator) for his help with the illustrations. FootnoteConflicts of Interest: The authors have no conflicts of interest to declare.

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“…Dexmedetomidine is a highly selective α 2 adrenergic receptor agonist that hypnotic, sedative, analgesic and anxiolytic actions and does not cause respiratory depression. Dexmedetomidine can also increase the analgesic e cacy of opioids [7][8][9][10][11][12] . However, the mechanisms of the effect of dexmedetomidine when combined with opioids remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative and Postoperative Dexmedetomidine Combined With Sufentanil and Dezocine-based Patient-Controlled Intravenous Analgesia Increases Female Patients' Global Satisfaction Degree After Thoracoscopic Surgery: A Randomised Double-blind Controlled Trial

Yao

et al. 2020

Preprint

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Background：There are no studies on the use of dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia (PCIA) in females undergoing thoracic surgery. We postulate that introducing dexmedetomidine to a combination of dezocine-based PCA drugs and sufentanil will increase female patients' global satisfaction degree.Methods：One hundred fifty-two female patients with physical classification type I or II according to the American Society of Anesthesiologists undergoing thoracoscopic surgery were arbitrarily classified into two categories, either receiving sufentanil and dezocine-based PCIA (group C) or incorporating dexmedetomidine with sufentanil and dezocine-based PCIA (group D). The patients' global satisfaction degree, postoperative nausea and vomiting (PONV), PCA bolus, rescue analgesia requirements, drug-related adverse effects, rest and coughing visual analogue scale (VAS) ratings, and Ramsay sedation scores (RSS) were measured at 6, 12, 24, 36 and 48 h after surgery.Results：Compared with the C group, the patient satisfaction degree was significantly higher; pain scores at rest and coughing were significantly different at 6, 12, 24, 36 and 48 h postoperatively; less rescue analgesia and PCA bolus were required; and a lower incidence of PONV was found in the D group. There were non-significant trends for the sedation scores and drug-related adverse effects in both groups.Conclusions：Dexmedetomidine combined with sufentanil and dezocine increased female patients' global satisfaction degree after thoracoscopic surgery. This effect could be linked to the improvement in postoperative analgesia and reduction in postoperative nausea and vomiting; the combined treatment did not increase drug-related adverse effects in female patients.Trial registration: Chinese Clinical Trial Registry number, ChiCTR2000030429. Registered on March 1, 2020.

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Effect of Oxycodone Combined With Dexmedetomidine for Intravenous Patient-Controlled Analgesia After Video-Assisted Thoracoscopic Lobectomy

Cited by 34 publications

References 26 publications

Dexmedetomidine in perioperative acute pain management: a non-opioid adjuvant analgesic

Dexmedetomidine in perioperative acute pain management: a non-opioid adjuvant analgesic

Intramuscular stimulation as a novel alternative method of pain management after thoracic surgery

Intraoperative and Postoperative Dexmedetomidine Combined With Sufentanil and Dezocine-based Patient-Controlled Intravenous Analgesia Increases Female Patients' Global Satisfaction Degree After Thoracoscopic Surgery: A Randomised Double-blind Controlled Trial

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