scholarly journals hole-Course Application of Dexmedetomidine Combined with Ketorolac in Nonnarcotic Postoperative Analgesia for Patients with Lung Cancer Undergoing Thoracoscopic Surgery: A Randomized Control Trial

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. E185-E193
Author(s):  
Qing-ping Wen
Keyword(s):  
Inflammatory Response ◽  
Immune Function ◽  
Postoperative Analgesia ◽  
Randomized Control Trial ◽  
Thoracoscopic Surgery ◽  
Patient Controlled Analgesia ◽  
Postoperative Patient ◽  
Intravenous Analgesia ◽  
Randomized Control ◽  
Rescue Drug

BACKGROUND: Opioid-based postoperative analgesia provides adequate analgesia with much adverse effects and immunosuppression. Dexmedetomidine and ketorolac have properties of opioid-sparing, antiinflammation, and immune protection. OBJECTIVES: To investigate the efficacy and safety of whole-course application of dexmedetomidine combined with ketorolac in nonnarcotic postoperative analgesia and its effect on inflammatory response and immune function in thoracoscopic surgery of lung cancer. STUDY DESIGN: Double-blind, randomized control trial. SETTING: The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China. METHODS: Sixty patients scheduled for thoracoscopic surgery were enrolled and randomly divided into 2 groups to receive a combination of intraoperative usage of dexmedetomidine and postoperative patient-controlled intravenous analgesia of dexmedetomidine 0.1 µg/kg/h and ketorolac 3 mg/kg (DEX group) or only postoperative patient-controlled intravenous analgesia of sufentanil 1.5 µg/kg and ketorolac 3 mg/kg (SUF group) for 48 hours. Vital signs, postoperative Visual Analog Scale (VAS) score, Ramsay sedation score, patient-controlled analgesia pressing times, consumption of sufentanil and rescue drug, and complications were compared between the 2 groups. The levels of inflammatory factors and immune function were also compared. RESULTS: A significant reduction in median blood pressures and heart rates within 48 hours after surgery and perioperative consumption of sufentanil were observed in the DEX group compared with the SUF group (P < 0.05). No statistically significant difference was found in VAS scores, patient-controlled analgesia pressing times, and rescue drug consumption between the 2 groups (P > 0.05). The incidence of nausea was significantly lower in the DEX group compared with the SUF group (P < 0.05). A significant decrease of interleukin (IL)-1 beta, IL-6, tumor necrosis factor (TNF)-alpha, and increased CD4+ and CD4+/CD8+ were observed in the DEX group compared with the SUF group at 24 and 48 hours after surgery (P < 0.05). There was no difference in the levels of CD8+ and natural killer cells between the 2 groups (P > 0.05). LIMITATIONS: This study was limited by its sample size. CONCLUSIONS: Whole-course application of dexmedetomidine combined with ketorolac in nonnarcotic postoperative analgesia provided adequate and safe postoperative analgesia, reduced sufentanil consumption, analgesia-related complications, alleviated inflammatory response, and immunosuppression compared with sufentanil-based analgesia in thoracoscopic surgery. KEY WORDS: Dexmedetomidine, ketorolac, sufentanil, thoracoscopic surgery, postoperative analgesic, patient-controlled analgesia, inflammatory response, immune function

scholarly journals Clinical effect of dexmedetomidine combined with sufentanil on postoperative analgesia for transthoracic device closure of ventricular septal defects in children with ultrafast track anesthesia

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jing Wang ◽  
Wen-Peng Xie ◽  
Yu-Qing Lei ◽  
Zeng-Chun Wang ◽  
Hua Cao ◽  
...  
Keyword(s):  
Postoperative Analgesia ◽  
Clinical Effect ◽  
The Other ◽  
Ventricular Septal Defects ◽  
Patient Controlled Analgesia ◽  
Device Closure ◽  
Postoperative Patient ◽  
Septal Defects ◽  
Intravenous Analgesia ◽  
Ramsay Score

Abstract Background To observe the effect of combining dexmedetomidine with sufentanil on postoperative analgesia in children who underwent transthoracic device closure of ventricular septal defects (VSDs) with ultrafast track anesthesia. Methods This was a retrospective study. Eighty-seven children who underwent transthoracic device closure of VSDs were retrospectively analyzed. Patients were divided into three groups based on the different drugs used for postoperative patient-controlled analgesia. Results No statistically significant differences in hemodynamic parameters were noted among the three groups after surgery (p > 0.05). The FLACC score in the SD2 group was significantly greater than those in the S groups and SD1 groups after surgery (p < 0.001). The Ramsay score in the S group was significantly lower than that of the SD1 and SD2 groups at 6 h (p < 0.001 and p = 0.003), 12 h (p = 0.002 and p = 0.012), and 24 h (p < 0.001 and p < 0.001) after surgery. The pressing frequency of the analgesic pump 48 h after the operation in the SD2 group was significantly greater than that in the other two groups (p < 0.05). The incidences of respiratory depression, nausea, and vomiting in the S group were significantly greater than those in the SD1 and SD2 groups (p < 0.05). Conclusion The combination of 0.04 μg/kg/h dexmedetomidine and 0.04 μg/kg/h sufentanil intravenous analgesia was more effective than the other two analgesic strategies in children who underwent transthoracic device closure of ventricular septal defects (VSDs) with ultrafast track anesthesia.

Postoperative patient-controlled analgesia: Meta-analyses of initial randomized control trials

1993 ◽  
Vol 5 (3) ◽  
pp. 182-193 ◽  
Author(s):  
Jane C. Ballantyne ◽  
Daniel B. Carr ◽  
Thomas C. Chalmers ◽  
Keith B.G. Dear ◽  
Italo F. Angelillo ◽  
...  
Keyword(s):  
Randomized Control Trials ◽  
Patient Controlled Analgesia ◽  
Postoperative Patient ◽  
Randomized Control ◽  
Meta Analyses

Efficacy of Postoperative Patient-controlled and Continuous Infusion Epidural Analgesia versus  Intravenous Patient-controlled Analgesia with Opioids

2005 ◽  
Vol 103 (5) ◽  
pp. 1079-1088 ◽  
Author(s):  
Christopher L. Wu ◽  
Seth R. Cohen ◽  
Jeffrey M. Richman ◽  
Andrew J. Rowlingson ◽  
Genevieve E. Courpas ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Meta Analysis ◽  
Epidural Infusion ◽  
Patient Controlled Analgesia ◽  
Analgesic Agent ◽  
Postoperative Patient ◽  
Continuous Epidural Infusion ◽  
Pain At Rest

The authors performed a meta-analysis and found that epidural analgesia overall provided superior postoperative analgesia compared with intravenous patient-controlled analgesia. For all types of surgery and pain assessments, all forms of epidural analgesia (both continuous epidural infusion and patient-controlled epidural analgesia) provided significantly superior postoperative analgesia compared with intravenous patient-controlled analgesia, with the exception of hydrophilic opioid-only epidural regimens. Continuous epidural infusion provided statistically significantly superior analgesia versus patient-controlled epidural analgesia for overall pain, pain at rest, and pain with activity; however, patients receiving continuous epidural infusion had a significantly higher incidence of nausea-vomiting and motor block but lower incidence of pruritus. In summary, almost without exception, epidural analgesia, regardless of analgesic agent, epidural regimen, and type and time of pain assessment, provided superior postoperative analgesia compared to intravenous patient-controlled analgesia.

Sign in / Sign up

Export Citation Format

Share Document