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Effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia on pain attenuation after open gastrectomy in comparison with conventional thoracic epidural and fentanyl-based intravenous patient-controlled analgesia

Authors
 Na Young Kim  ;  Tae Dong Kwon  ;  Sun Joon Bai  ;  Sung Hoon Noh  ;  Jung Hwa Hong  ;  Haeyeon Lee  ;  Ki-Young Lee 
Citation
 INTERNATIONAL JOURNAL OF MEDICAL SCIENCES, Vol.14(10) : 951-960, 2017 
Journal Title
 INTERNATIONAL JOURNAL OF MEDICAL SCIENCES 
Issue Date
2017
MeSH
Administration, Intravenous ; Adrenergic alpha-2 Receptor Agonists/therapeutic use* ; Aged ; Analgesia, Epidural/methods ; Analgesia, Patient-Controlled/methods ; Analgesics, Opioid/therapeutic use* ; Dexmedetomidine/administration & dosage ; Dexmedetomidine/therapeutic use* ; Drug Therapy, Combination/methods ; Female ; Fentanyl/therapeutic use* ; Gastrectomy/adverse effects* ; Humans ; Male ; Middle Aged ; Pain Management/methods ; Pain Measurement ; Pain, Postoperative/drug therapy* ; Pain, Postoperative/etiology ; Prospective Studies
Keywords
dexmedetomidine ; epidural ; fentanyl ; intravenous ; patient-controlled analgesia ; postoperative pain
Abstract
Background: This study was investigated the effects of dexmedetomidine in combination with fentanyl-based intravenous patient-controlled analgesia (IV-PCA) on pain attenuation in patients undergoing open gastrectomy in comparison with conventional thoracic epidural patient-controlled analgesia (E-PCA) and IV-PCA. Methods: One hundred seventy-one patients who planned open gastrectomy were randomly distributed into one of the 3 groups: conventional thoracic E-PCA (E-PCA group, n = 57), dexmedetomidine in combination with fentanyl-based IV-PCA (dIV-PCA group, n = 57), or fentanyl-based IV-PCA only (IV-PCA group, n = 57). The primary outcome was the postoperative pain intensity (numerical rating scale) at 3 hours after surgery, and the secondary outcomes were the number of bolus deliveries and bolus attempts, and the number of patients who required additional rescue analgesics. Mean blood pressure, heart rate, and adverse effects were evaluated as well. Results: One hundred fifty-three patients were finally completed the study. The postoperative pain intensity was significantly lower in the dIV-PCA and E-PCA groups than in the IV-PCA group, but comparable between the dIV-PCA group and the E-PCA group. Patients in the dIV-PCA and E-PCA groups needed significantly fewer additional analgesic rescues between 6 and 24 hours after surgery, and had a significantly lower number of bolus attempts and bolus deliveries during the first 24 hours after surgery than those in the IV-PCA group. Conclusions: Dexmedetomidine in combination with fentanyl-based IV-PCA significantly improved postoperative analgesia in patients undergoing open gastrectomy without hemodynamic instability, which was comparable to thoracic E-PCA. Furthermore, this approach could be clinically more meaningful owing to its noninvasive nature.
Files in This Item:
T201703080.pdf Download
DOI
10.7150/ijms.20347
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kweon, Tae Dong(권태동) ORCID logo https://orcid.org/0000-0002-5451-1856
Kim, Na Young(김나영) ORCID logo https://orcid.org/0000-0003-3685-2005
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Bae, Il Kwon(배일권)
Lee, Ki Young(이기영) ORCID logo https://orcid.org/0000-0003-4893-3195
Lee, Haeyeon(이해연) ORCID logo https://orcid.org/0000-0001-8065-9590
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160703
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