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Published in: BMC Anesthesiology 1/2017

Open Access 01-12-2017 | Research article

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

Authors: Minju Qin, Kaizheng Chen, Tingjie Liu, Xia Shen

Published in: BMC Anesthesiology | Issue 1/2017

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Abstract

Background

Dexmedetomidine as an adjunct with opioids has been confirmed to spare opioids usage and improve analgesia for postoperative pain treatment. Furthermore, dexmedetomidine can attenuate the airway reflex. The aim of this study is to assess the safety and efficacy of dexmedetomidine combined with sufentanil for postoperative analgesia after partial laryngectomy.

Methods

A total of 60 adult male patients were recruited and randomly allocated to receive sufentanil 1.0 μg ml−1 (Group S) or sufentanil 1.0 μg ml−1 plus dexmedetomidine 4 μg ml−1 (Group SD) for postoperative analgesia. The IV patient controlled analgesia (PCA) device was programmed to deliver 1.5 ml per demand with a 10 min lockout interval and 1.5 ml per hour background infusion. Cumulative consumption of sufentanil and pain intensity during 24 hour (h) after surgery were recorded. Coughing episodes per day, sleep quality, hemodynamic and respiratory profiles were measured.

Results

Compared with Group S, patients in Group SD required less sufentanil during the 0–24 h postoperative period (p < 0.0001) and reported significant lower pain intensity from the second postoperative hour to the end of the study (P < 0.0001). Daily coughing episodes, sleep disturbance was lower and patients’ satisfaction was higher in Group SD (P < 0.05). Decrease in heart rate and mean blood pressure from baseline at 1 h, 2 h, 3 h, 12 h, and 24 h after operation were significantly greater in Group SD (P = 0.00). The incidence of PCA related adverse events were comparable between the two groups.

Conclusion

Dexmedetomidine/sufentanil combination for postoperatjve analgesia in partial laryngectomized patients resulted in significant sufentanil sparing, better analgesia, reduced frequency coughing episodes, and better sleep quality.

Trial registration

Chinese Clinical Registry (ChiCTR): ChiCTR-TRC-14004618, date of registration: 08 May 2014.
Literature
1.
go back to reference Mom T, Bazin JE, Commun F, Dubray C, Eschalier A, Derbal C, et al. Assessment of postoperative pain after laryngeal surgery for cancer. Arch Otolaryngol Head Neck Surg. 1998;124:794–8.CrossRefPubMed Mom T, Bazin JE, Commun F, Dubray C, Eschalier A, Derbal C, et al. Assessment of postoperative pain after laryngeal surgery for cancer. Arch Otolaryngol Head Neck Surg. 1998;124:794–8.CrossRefPubMed
2.
go back to reference Hilgers FJ, Ackerstaff AH, Aaronson NK, Schouwenburg PF, Van Zandwijk N. Physical and psychosocial consequences of total laryngectomy. Clin Otolaryngol Allied Sci. 1990;15:421–5.CrossRefPubMed Hilgers FJ, Ackerstaff AH, Aaronson NK, Schouwenburg PF, Van Zandwijk N. Physical and psychosocial consequences of total laryngectomy. Clin Otolaryngol Allied Sci. 1990;15:421–5.CrossRefPubMed
3.
go back to reference Mérol JC, Charpiot A, Langagne T, Hémar P, Ackerstaff AH, Hilgers FJ. Randomized controlled trial on pastoperatvie pulmonary humidification after total laryngectomy: external humidifier versus heat and moisture exchanger. Laryngoscope. 2012;122:275–81.CrossRefPubMed Mérol JC, Charpiot A, Langagne T, Hémar P, Ackerstaff AH, Hilgers FJ. Randomized controlled trial on pastoperatvie pulmonary humidification after total laryngectomy: external humidifier versus heat and moisture exchanger. Laryngoscope. 2012;122:275–81.CrossRefPubMed
4.
go back to reference Lin TF, Yeh YC, Lin FS, Wang YP, Lin CJ, Sun WZ, et al. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia. Br J Anaesth. 2009;102:117–22.CrossRefPubMed Lin TF, Yeh YC, Lin FS, Wang YP, Lin CJ, Sun WZ, et al. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia. Br J Anaesth. 2009;102:117–22.CrossRefPubMed
5.
go back to reference Peng K, liu HY, Wu SR, Cheng H, Ji FH. Effects of combining dexmedetomidine and opioids for postoperative intravenous patients controlled analgesia: a systematic review and meta-analysis. Clin J Pain. 2015;13:1097–104.CrossRef Peng K, liu HY, Wu SR, Cheng H, Ji FH. Effects of combining dexmedetomidine and opioids for postoperative intravenous patients controlled analgesia: a systematic review and meta-analysis. Clin J Pain. 2015;13:1097–104.CrossRef
6.
go back to reference Alexopoulou C, Kondili E, Diamantaki E, Psarologakis C, Kokkini S, Bolaki M, et al. Effects of dexmedetomidine on sleep quality in critically ill patients: A pilot study. Anesthesiology. 2014;121:801–7.CrossRefPubMed Alexopoulou C, Kondili E, Diamantaki E, Psarologakis C, Kokkini S, Bolaki M, et al. Effects of dexmedetomidine on sleep quality in critically ill patients: A pilot study. Anesthesiology. 2014;121:801–7.CrossRefPubMed
7.
go back to reference Hu R, Liu JX, Jiang H. Dexmedetomidine versus remifentanil sedation during awake fiberoptic nasotracheal intubation: a double-blinded randomized controlled trial. J Anesth. 2013;27:211–7.CrossRefPubMed Hu R, Liu JX, Jiang H. Dexmedetomidine versus remifentanil sedation during awake fiberoptic nasotracheal intubation: a double-blinded randomized controlled trial. J Anesth. 2013;27:211–7.CrossRefPubMed
9.
go back to reference Arain SR, Ruehlow RM, Uhrich TD, Ebert TJ. The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery. Anesth Analg. 2004;98:153–8.CrossRefPubMed Arain SR, Ruehlow RM, Uhrich TD, Ebert TJ. The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery. Anesth Analg. 2004;98:153–8.CrossRefPubMed
10.
go back to reference Unlugenc H, Gunduz M, Guler T, Yagmur O, Isik G. The effect of pre-anaesthetic administration of intravenous dexmedetomidine on postoperative pain in patients receiving patient-controlled morphine. Eur J Anaesthesiol. 2005;22:386–91.CrossRefPubMed Unlugenc H, Gunduz M, Guler T, Yagmur O, Isik G. The effect of pre-anaesthetic administration of intravenous dexmedetomidine on postoperative pain in patients receiving patient-controlled morphine. Eur J Anaesthesiol. 2005;22:386–91.CrossRefPubMed
11.
go back to reference Nho JS, Lee SY, Kang JM, Kim MC, Choi YK, Shin OY, et al. Effects of maintaining a remifentanil infusion on the recovery profiles during emergence from anesthesia and tracheal extubation. Br J Anaesth. 2009;103:817–21.CrossRefPubMed Nho JS, Lee SY, Kang JM, Kim MC, Choi YK, Shin OY, et al. Effects of maintaining a remifentanil infusion on the recovery profiles during emergence from anesthesia and tracheal extubation. Br J Anaesth. 2009;103:817–21.CrossRefPubMed
12.
go back to reference Ryu JH, Lee SW, Lee JH, Lee EH, Do SH, Kim CS. Randomized double-blind study of remifentanil and dexmedetomidine for flexible bronchoscopy. Br J Anaesth. 2012;108:503–11.CrossRefPubMed Ryu JH, Lee SW, Lee JH, Lee EH, Do SH, Kim CS. Randomized double-blind study of remifentanil and dexmedetomidine for flexible bronchoscopy. Br J Anaesth. 2012;108:503–11.CrossRefPubMed
13.
go back to reference Bussian C, Wollbrück D, Danker H, Herrmann E, Thiele A, Dietz A, et al. Mental health after laryngectomy and partial laryngectomy: a comparative study. Eur Arch Otorhinolaryngol. 2010;267:261–6.CrossRefPubMed Bussian C, Wollbrück D, Danker H, Herrmann E, Thiele A, Dietz A, et al. Mental health after laryngectomy and partial laryngectomy: a comparative study. Eur Arch Otorhinolaryngol. 2010;267:261–6.CrossRefPubMed
Metadata
Title
Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy
Authors
Minju Qin
Kaizheng Chen
Tingjie Liu
Xia Shen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2017
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-017-0363-x

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