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Comparison of the Efficacy of Dexmedetomidine plus Fentanyl Patient-controlled Analgesia with Fentanyl Patient-controlled Analgesia for Pain Control in Uterine Artery Embolization for Symptomatic Fibroid Tumors or Adenomyosis: A Prospective, Randomized Study

Authors
 So Yeon Kim  ;  Chul Ho Chang  ;  Jong Seok Lee  ;  Yoon Jae Kim  ;  Man Deuk Kim  ;  Dong Woo Han 
Citation
 Journal of Vascular and Interventional Radiology, Vol.24(6) : 779-786, 2013 
Journal Title
 Journal of Vascular and Interventional Radiology 
ISSN
 1051-0443 
Issue Date
2013
MeSH
Adenomyosis/complications ; Adenomyosis/therapy* ; Adjuvants, Anesthesia/administration & dosage ; Analgesics, Non-Narcotic/administration & dosage ; Chemoembolization, Therapeutic/adverse effects ; Dexmedetomidine/administration & dosage* ; Drug Therapy, Combination ; Female ; Fentanyl/administration & dosage* ; Humans ; Leiomyoma/complications ; Leiomyoma/therapy* ; Pain/drug therapy* ; Pain/etiology* ; Pain Measurement/drug effects ; Premedication/methods ; Prospective Studies ; Self Administration ; Treatment Outcome ; Uterine Artery Embolization/adverse effects* ; Uterine Neoplasms/complications ; Uterine Neoplasms/therapy*
Keywords
Adenomyosis/complications ; Adenomyosis/therapy* ; Adjuvants, Anesthesia/administration & dosage ; Analgesics, Non-Narcotic/administration & dosage ; Chemoembolization, Therapeutic/adverse effects ; Dexmedetomidine/administration & dosage* ; Drug Therapy, Combination ; Female ; Fentanyl/administration & dosage* ; Humans ; Leiomyoma/complications ; Leiomyoma/therapy* ; Pain/drug therapy* ; Pain/etiology* ; Pain Measurement/drug effects ; Premedication/methods ; Prospective Studies ; Self Administration ; Treatment Outcome ; Uterine Artery Embolization/adverse effects* ; Uterine Neoplasms/complications ; Uterine Neoplasms/therapy*
Abstract
PURPOSE: To investigate whether dexmedetomidine infusion could reduce opioid consumption and opioid-related side effects after uterine artery embolization (UAE). MATERIALS AND METHODS: Fifty patients undergoing UAE for symptomatic leiomyomas or adenomyosis were randomized into two groups. In 25 patients, dexmedetomidine infusion was started at 0.2 μg/kg/h at 30 minutes before the procedure, followed by 0.4 μg/kg/h for 6 hours after the procedure. In another 25 patients (control group), volume-matched normal saline solution was administered. Both groups received fentanyl-based intravenous patient-controlled analgesia (PCA; fentanyl 10 μg/h with a bolus dose of 20 μg) during the 24 hours after the procedure. Nonspherical polyvinyl alcohol particles were used. Pain scores, fentanyl consumption, need for additional analgesics, and side effects were assessed for 24 hours after UAE. RESULTS: Compared with the control group, patients in the dexmedetomidine group required 28% less PCA fentanyl during the 24 hours after UAE (P = .006). Numeric rating scale scores for pain (5.0±2.4 vs 7.0±2.2; P = .026) and the need for additional analgesics (two of 25 vs 17 of 25; P<.001) were lower in the dexmedetomidine group than in the control group during the first 1 hour after UAE. The incidence and severity of nausea and vomiting during the 24 hours after UAE were lower in the dexmedetomidine group than in the control group (P < .05). CONCLUSIONS: The addition of dexmedetomidine infusion to fentanyl PCA provides better analgesia, fentanyl-sparing effect, and less nausea and vomiting, without significant hemodynamic instability.
Full Text
http://www.sciencedirect.com/science/article/pii/S1051044313007227
DOI
10.1016/j.jvir.2013.02.034
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 Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Lee, Jong Seok(이종석) ORCID logo https://orcid.org/0000-0002-7945-2530
Chang, Chul Ho(장철호) ORCID logo https://orcid.org/0000-0001-5647-8298
Han, Dong Woo(한동우) ORCID logo https://orcid.org/0000-0002-8757-663X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87171
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