Comparative study between the effect of dexmedetomidine and lidocaine infusion in lumbar fixation on hemodynamics, fenta
- PDF / 961,474 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 52 Downloads / 191 Views
Ain-Shams Journal of Anesthesiology
(2020) 12:67
ORIGINAL ARTICLE
Open Access
Comparative study between the effect of dexmedetomidine and lidocaine infusion in lumbar fixation on hemodynamics, fentanyl requirements, and postoperative analgesia Nayera S. Mohammed*, Mariam K. Habib, Essam A. Abbas, Sahar M. Mahmoud and Ibraheem A. Ramadan
Abstract Background: Spinal surgery is associated with high incidence of severe postoperative pain difficult to easy control. Appropriate treatment modalities decreased the postoperative morbidity, increased patient satisfaction, allowed early mobility, and decreased hospital costs. Lidocaine was used as intravenous additives to control intraoperative pain and decrease postoperative pain. As lidocaine, dexmedetomidine infusion associated with lower postoperative pain scores decreased the opioid consumption and its related adverse events. The aim of this double blind randomized prospective comparative study was to compare the efficacy of intraoperative dexmedetomidine versus lidocaine infusion on hemodynamics, fentanyl requirements, and postoperative analgesia among 66 patients subjected to lumbar fixation surgery and randomized into group D which received dexmedetomidine 1 μg/kg infusion over 10 min as a loading dose then 0.3–0.5 μg/kg/h after induction of anesthesia as maintenance dose and group X which received lidocaine 0.3–0.5 mg/kg/h after induction of anesthesia. Results: At 10, 15, 30, and 60 min, the mean arterial blood pressure and heart rate significantly decreased in group D compared to group X, and there was significantly higher total dose of intraoperative analgesic for fentanyl in group X than group D. There was significantly higher numeric rating scale in group X compared to group D at 2, 4, 6, 9, 12, 18, and 24 h postoperative with significant early request of the first analgesia, higher incidence of analgesic needs, and higher dose of postoperative analgesia paracetamol, voltaren, or pethidine in group X compared to group D. Conclusions: The intraoperative use of dexmedetomidine IV infusion was an alternative mode to decrease the demands of analgesia following spine surgery. Keywords: Dexmedetomidine, Fixation, Lidocaine, Nausea, Pain, Sedation score, Vomiting
Background Postoperative pain is one of the most common complications after surgery and associated with higher incidence of nausea and vomiting, increased risk of thromboembolic manifestation, and postoperative cognitive dysfunction. Opioid medications were used commonly to control postoperative pain, but it was * Correspondence: [email protected] Department of Anesthesiology, Intensive care and Pain Management, Faculty of Medicine, Ain-Shams University, Abbassia, Cairo 11591, Egypt
associated with higher risk of side effects mainly nausea and constipation (Hurley and Wu 2010). Dexmedetomidine was a selective alpha 2 agonist as clonidine, but it has a greater affinity to the alpha 2 receptor with hypnotic properties similar to natural sleep and effectively attenuates the stress response to the s
Data Loading...
