Does dexmedetomidine infusion reduce the postoperative analgesic need in lumbar disc surgery?

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Turkish Journal of Medical Sciences Pub Date : 2025-03-24 eCollection Date: 2025-01-01 DOI:10.55730/1300-0144.5991
Sibel Çatalca, Özlem Özmete, Numan Berk, Soner Çivi, Emre Durdağ, Caner Incekaş, Nesrin Bozdoğan Özyilkan
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引用次数: 0

Abstract

Background/aim: Patients experience moderate-to-severe pain, especially in the first days after lumbar disc surgery. Poorly controlled pain in the postoperative period negatively affects patient outcomes. Dexmedetomidine is a highly selective α2 adrenoceptor agonist with demonstrated analgesic efficacy. However, conflicting results have been reported in the current literature regarding the efficacy of dexmedetomidine in this surgery. In this study, we tested the hypothesis that dexmedetomidine safely improves pain scores and reduces opioid consumption in lumbar microdiscectomy.

Materials and methods: Medical records of patients who underwent lumbar microdiscectomy with general anesthesia between January 2023 and October 2023 were retrospectively reviewed. Patients who met the inclusion criteria were divided into two groups as those who did not receive dexmedetomidine infusion (Group A) and those who received dexmedetomidine infusion (Group B). Patients in Group B received a loading dose of 1 μg/kg dexmedetomidine followed by a maintenance infusion of 0.5 μg/kg/h. The primary outcome of our study was postoperative fentanyl consumption at the 24th h. Secondary outcomes of our study included need for fentanyl in the recovery unit, postoperative pain scores at the 2nd, 6th, 12th, and 24th h and fentanyl consumption at the 2nd, 6th, and 12th h and perioperative complications.

Results: A total of 68 patients were included in our study, 34 patients in each group. The number of patients requiring fentanyl in the recovery unit and the dose of fentanyl administered were similar in both groups (p = 0.223 and p = 0.373, respectively). There was no statistical difference in the pain scores, opioid consumption, and perioperative complications at the 2nd, 6th, 12th, and 24th h after surgery in patients receiving dexmedetomidine compared to the control group (p > 0.05).

Conclusion: Intraoperative dexmedetomidine infusion did not reduce postoperative pain intensity and opioid consumption in patients undergoing lumbar microdiscectomy under general anesthesia.

右美托咪定输注是否减少腰椎间盘手术术后镇痛需求?
背景/目的:患者经历中度至重度疼痛,特别是在腰椎间盘手术后的第一天。术后疼痛控制不佳会对患者的预后产生负面影响。右美托咪定是一种高选择性α2肾上腺素能受体激动剂,具有明显的镇痛作用。然而,关于右美托咪定在该手术中的疗效,目前的文献报道了相互矛盾的结果。在这项研究中,我们检验了右美托咪定在腰椎微椎间盘切除术中安全改善疼痛评分和减少阿片类药物消耗的假设。材料与方法:回顾性分析2023年1月至2023年10月行全麻腰微椎间盘切除术患者的病历。符合纳入标准的患者分为未输注右美托咪定组(A组)和输注右美托咪定组(B组)。B组患者给予右美托咪定负荷剂量1 μg/kg,维持输注0.5 μg/kg/h。本研究的主要结局是术后第24小时芬太尼的使用情况。次要结局包括恢复病房芬太尼的使用情况,术后第2、6、12、24小时的疼痛评分,第2、6、12小时芬太尼的使用情况以及围手术期并发症。结果:本研究共纳入68例患者,每组34例。两组在康复单元中需要芬太尼的患者人数和芬太尼给药剂量相似(p = 0.223和p = 0.373)。右美托咪定组术后2、6、12、24 h疼痛评分、阿片类药物消耗及围手术期并发症与对照组比较,差异均无统计学意义(p < 0.05)。结论:术中右美托咪定输注不能降低全麻下腰微椎间盘切除术患者术后疼痛强度和阿片类药物消耗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Turkish Journal of Medical Sciences
Turkish Journal of Medical Sciences 医学-医学:内科
CiteScore
4.60
自引率
4.30%
发文量
143
审稿时长
3-8 weeks
期刊介绍: Turkish Journal of Medical sciences is a peer-reviewed comprehensive resource that provides critical up-to-date information on the broad spectrum of general medical sciences. The Journal intended to publish original medical scientific papers regarding the priority based on the prominence, significance, and timeliness of the findings. However since the audience of the Journal is not limited to any subspeciality in a wide variety of medical disciplines, the papers focusing on the technical  details of a given medical  subspeciality may not be evaluated for publication.
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