Premedication with clonidine and dexmedetomidine as multimodal analgesia for overnight stay laparoscopic cholecystectomy: A randomized comparative study

IF 0.2 Q4 ANESTHESIOLOGY
Navneeta Bisht, T. Muniraju, A. Hasan, Vivek Kumar, D. Bhaumik
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引用次数: 0

Abstract

Background: Pain due to pneumoperitoneum after laparoscopic cholecystectomy (LC) may contribute to prolong hospital stay, patient discomfort, and failure of the surgery as an ambulatory procedure. A balanced multimodal analgesia regimen consisting of premedication with selective alpha-2 agonists is gaining popularity for postoperative pain relief for multiple surgeries. Although both clonidine (CLO) and dexmedetomidine (DEX) belong to this group, DEX is seen to have more selective α2 action and better sympatholytic properties. The present study aims to assess the coanalgesic effect of premedication with CLO and DEX for LC, done as an overnight stay procedure, and to compare their efficacy. Methodology: This was a prospective, randomized, single-blinded comparative study, conducted between July 2015 and July 2016. A total of 80 patients undergoing LC were randomly assigned to either CLO or DEX groups (n = 40). The patients were premedicated with low-dose (1 μg/kg) bolus intravenous drugs before induction according to the allotted group. Effect of individual drugs on the postoperative visual analog scale (VAS) score was noted, hemodynamic status was monitored, and analgesic-sparing effect to a multimodal analgesic regimen comprising intraoperative fentanyl and postoperative tramadol was noted. Results: VAS scores at 15 min postextubation, the number of patients required rescue analgesia, and the number of injections required were all found significantly low with DEX. Systolic as well as diastolic blood pressure was significantly lower in the DEX group. Conclusions: Although both the drugs were effective for short hospital stay LC, early pain relief and better hemodynamic stability were seen with DEX. Thus, routine premedication with DEX for ambulatory LC may be recommended.
可乐定和右美托咪定作为过夜腹腔镜胆囊切除术多模式镇痛的用药前随机对照研究
背景:腹腔镜胆囊切除术(LC)后气腹引起的疼痛可能会延长住院时间、患者不适以及作为门诊手术的失败。由选择性α-2激动剂在术前用药组成的平衡多模式镇痛方案在多次手术的术后镇痛中越来越受欢迎。尽管可乐定(CLO)和右美托咪定(DEX)都属于这一组,但DEX被认为具有更高的选择性α2作用和更好的交感神经溶解特性。本研究旨在评估CLO和DEX在LC术前的镇痛效果,并比较它们的疗效。方法:这是一项前瞻性、随机、单盲的比较研究,于2015年7月至2016年7月进行。共有80名接受LC的患者被随机分配到CLO或DEX组(n=40)。根据分配的组,患者在诱导前接受低剂量(1μg/kg)静脉推注药物的预处理。注意到个别药物对术后视觉模拟量表(VAS)评分的影响,监测血液动力学状态,并注意到对包括术中芬太尼和术后曲马多在内的多模式镇痛方案的镇痛保留效果。结果:拔管后15分钟的VAS评分、需要抢救性镇痛的患者数量和需要注射的次数均显著低于DEX。DEX组的收缩压和舒张压显著降低。结论:尽管这两种药物对短期住院LC都有效,但DEX可以早期缓解疼痛并改善血液动力学稳定性。因此,建议对门诊LC进行常规的DEX术前用药。
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来源期刊
Indian Anaesthetists Forum
Indian Anaesthetists Forum ANESTHESIOLOGY-
自引率
0.00%
发文量
17
审稿时长
6 weeks
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