Perioperative infusion of dexmedetomidine at a high dose reduces postoperative analgesic requirements: a randomized control trial

Ohtani, Norimasa; Yasui, Yutaka; Watanabe, Daisuke; Kitamura, Mitsunobu; Shoji, Kazuhiro; Masaki, Eiji

doi:10.1007/s00540-011-1239-8

Cited by 36 publications

(29 citation statements)

References 15 publications

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“…Dexmedetomidine is a potent sympatholytic agent, which can inhibit autonomic nervous system reactions such as increased heart rate and blood pressure following tracheal intubation and surgical stimuli; therefore, hemodynamic criteria may not be reliable for assessment of analgesic sufficiency. In addition, studies focusing on postoperative analgesic requirements after adjunctive DEX showed that the analgesic-sparing effect of DEX was confounded by its coexistent sedative and anxiolytic properties [7,8].…”

Section: Introductionmentioning

confidence: 98%

Remifentanil requirements for preventing motor response to skin incision in healthy women anesthetized with combinations of propofol and dexmedetomidine titrated to similar Bispectral Index (BIS) values

Hang

Chen

et al. 2014

Ir J Med Sci

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Section: Introductionmentioning

confidence: 98%

Remifentanil requirements for preventing motor response to skin incision in healthy women anesthetized with combinations of propofol and dexmedetomidine titrated to similar Bispectral Index (BIS) values

Hang

Chen

et al. 2014

Ir J Med Sci

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“…Dexmedetomidine is an a 2 -adrenoreceptor agonist with sedative and antinociceptive effects in humans, mice, dogs and cats (Sabbe et al 1994;Slingsby & Taylor 2008;Ohtani et al 2011;Rangel et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Alfaxalone versus alfaxalone–dexmedetomidine anaesthesia by immersion in oriental fire-bellied toads (Bombina orientalis)

Adami

d’Ovidio²,

Casoni

2016

Veterinary Anaesthesia and Analgesia

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“…This delayed analgesic request parallels the delay in patients receiving dexmedetomidine during general anesthesia. 28 It is important to emphasize that, although the level of sedation was measured in the operating room as well as in the PACU, in every case, the first analgesic demand occurred on the ward via PCA where the patient's level of sedation was not measured.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trial

Chan

Maslany

Gorman

et al. 2016

Can J Anesth/J Can Anesth

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Background It remains unclear whether the opioidsparing effects of dexmedetomidine seen in patients undergoing general anesthesia are reproducible in patients undergoing spinal anesthesia. We hypothesized that the administration of intravenous dexmedetomidine for sedation during total knee arthroplasty under spinal anesthesia would decrease postoperative morphine consumption in the first 24 hr following surgery. Methods We conducted this prospective double-blind randomized-controlled trial in 40 patients (American Society of Anesthesiologists physical status I-III) undergoing total knee arthroplasty with a standardized spinal anesthetic. Patients were randomized to receive either a dexmedetomidine loading dose of 0.5 lgÁkg -1 over ten minutes, followed by an infusion of 0.5 lgÁkgÁhr -1 for the duration of the surgery, or a normal saline loading dose and an infusion of an equivalent volume. The primary outcome was the consumption of morphine delivered via patientcontrolled analgesia in the first 24 hr following surgery. Results The mean (SD) cumulative morphine at 24 hr in the dexmedetomidine group was 29.2 (11.2) mg compared with 61.2 (17.2) mg in the placebo group (mean difference, 32.0 mg; 95% confidence interval, 22.7 to 41.2; P \ 0.001). In the dexmedetomidine group, there was a delay in the time to first analgesic request (P = 0.003) and a reduction in the mean morphine use at six and 12 hr following surgery (both P \ 0.001).Conclusions Dexmedetomidine was associated with a significant decrease in morphine use in the first 24 hr following total knee arthroplasty. Our study shows that an intraoperative infusion of dexmedetomidine for sedation in patients receiving spinal anesthesia can produce postoperative analgesic effects. This offers another potential adjunct in the multimodal pain management of these patients. This trial was registered at ClinicalTrials.gov (identifier NCT02026141).

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Perioperative infusion of dexmedetomidine at a high dose reduces postoperative analgesic requirements: a randomized control trial

Abstract: Among this small patient cohort, perioperative infusion of dexmedetomidine (1 μg/kg/h) resulted in antinociception without severe side effects. These results suggest that this method could be of interest with respect to improving postoperative pain status.

Cited by 36 publications

References 15 publications

Remifentanil requirements for preventing motor response to skin incision in healthy women anesthetized with combinations of propofol and dexmedetomidine titrated to similar Bispectral Index (BIS) values

Remifentanil requirements for preventing motor response to skin incision in healthy women anesthetized with combinations of propofol and dexmedetomidine titrated to similar Bispectral Index (BIS) values

Alfaxalone versus alfaxalone–dexmedetomidine anaesthesia by immersion in oriental fire-bellied toads (Bombina orientalis)

Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trial

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