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17525

The analgesic and sedative properties of dexmedetomidine infusion after uvulopalatopharyngoplasty

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Last updated: 03 Jan 2025

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Abstract

Background: Dexmedetomidine is an alpha2 - adrenergic agonist with sedative andanalgesic properties. This study aimed to investigate if the use of continuous dexmedetomidine infusion with i.v. morphine patient-controlled analgesia (PCA) could improve postoperative analgesia while reducing opioid consumption and opioid-related side effects. Materials & methods: In this prospective randomized, double-blinded, controlled study, 24 patients with obstructive sleep apnea syndrome undergoing uvulopalatopharyngoplasty were assigned to two groups. Group D received a loading dose of dexmedetomidine 1µg kgˉ¹  i.v., 30 min before the anticipated end of surgery, followed by a continuous infusion at a rate of 0.6 µg  kgˉ¹ hrˉ¹ for 24 hr. Group P received a volume-matched bolus and infusion of placebo. In both groups, postoperative pain was initially controlled by i.v. morphine titration and then PCA with morphine.  Cumulative PCA morphine consumption, pain intensities, sedation scores, cardiovascular and respiratory variables and narcotic-related adverse effects were recorded for 48 h after operation. Results: Extubation time was significantly prolonged in dexmedetomidine group (16±7 vs. 11±6 min p=0.074) in the placebo group. Visual analogue scale scores were significantly greater during the first 2h after tracheal extubation in the placebo group than in the dexmedetomidine group. The time to first analgesic request was significantly longer in the dexmedetomidine group than in the placebo group (21±11 vs. 9±4min; p=0.002). Compared with group P, patients in group D required 52.7% less morphine by PCA during the first 24h postoperative period, whereas levels of sedation were similar between the 2 groups at each observational time point. Fewer patients in group D experienced nausea and vomiting than those in group P (P< 0.05). There was no bradycardia, hypotension, or respiratory depression. Continuous dexmedetomidine infusion may be a useful anesthetic adjuvant for patients who are susceptible to narcotic-induced respiratory depression. Conclusion: Continuous infusion of dexmedetomidine for pain relief after uvulopalatopharyngoplasty significantly reduces the amount of PCA morphine used by the patients postoperatively without affecting their ventilatory parameters and was associated with fewer morphine-related side effects. This novel drug could become a useful anesthetic adjuvant for patients with obstructive sleep apnea who are susceptible to narcotic-induced respiratory depression.  

DOI

10.21608/ejhm.2009.17525

Keywords

Dexmedetomidine, Uvulopalatophayngoplasty, morphine, Patient controlled analgesia

Authors

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Last Name

Abd El Megid

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Affiliation

Department of Anesthesia and Intensive Care, Ain Shams University

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First Name

Ahmed M.

Last Name

Nassar

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Affiliation

Department of ENT, Al Azhar University.

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Volume

36

Article Issue

1

Related Issue

3686

Issue Date

2009-07-01

Receive Date

2018-10-24

Publish Date

2009-07-01

Page Start

421

Page End

433

Print ISSN

1687-2002

Online ISSN

2090-7125

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https://ejhm.journals.ekb.eg/article_17525.html

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https://ejhm.journals.ekb.eg/service?article_code=17525

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4

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Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

The analgesic and sedative properties of dexmedetomidine infusion after uvulopalatopharyngoplasty

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Article

Created At

22 Jan 2023