Effects of Dexmedetomidine on Stress Response and Postoperative Analgesia

Fang Luo60 enrolled

Overview

Dexmedetomidine is a highly selective α2 adrenoreceptor agonist approved by the US FDA for short-term postoperative sedation and analgesia.It can also reduce the stress response without respiratory depression. In this prospective, randomized, double-blind, placebo-controlled study，we gave dexmedetomidine or saline placebo 1h before operations were over and assessed the effects of dexmedetomidine on stress response and postoperative analgesia in patients undergoing thoracotomy during anesthesia recovery period.

Dexmedetomidine can significantly reduce the emergence agitation and postoperative pain in patients who received chest surgery

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

QUADRUPLE

Enrollment

Conditions

Restlessness Pain

Interventions

dexmedetomidineDRUG

In this arm,midazolam(0.03-0.05mg/kg), propofol(1.5-2.5mg/kg),sufentanil(0.6-0.82μg/kg )and rocuronium(0.8-1.0mg/kg) were used in anesthesia induction. Anaesthesia was maintained with propofol（4-6mg kg-1h-1），remifentanil (0.1-0.2 μg kg-1 min-1）and sevoflurane（1%).Propofol was titrated to maintain intraoperative Narcotrend values between 20 and 46. Patients in this arm received dexmedetomidine 0.2μg/kg i.v. during 10 minutes 1 hour before the end of surgery

saline placeboDRUG

In this arm,midazolam(0.03-0.05mg/kg), propofol(1.5-2.5mg/kg),sufentanil(0.6-0.82μg/kg )and rocuronium(0.8-1.0mg/kg) were used in anesthesia induction. Anaesthesia was maintained with propofol（4-6mg kg-1h-1），remifentanil (0.1-0.2 μg kg-1 min-1）and sevoflurane（1%).Propofol was titrated to maintain intraoperative Narcotrend values between 20 and 46. Patients in this arm received saline placebo of the same volume i.v. during 10 minutes 1 hour before the end of surgery

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anaesthesiologists Physical Status (ASA-PS) I or II * undergoing selective thoracotomy * weight between 45 and 75kg * operation time 2-4 hours Exclusion Criteria: * history of neurologic disease * history of chronic analgesics intake * history of allergic reactions to the experimental durgs * history of renal insufficiency * history of hepatic dysfunction * history of coagulation disorders * women in lactation * participating in other studies

Outcomes

Primary Outcomes

Emergence agitation

Emergence agitation was assessed by the highest restlessness score（RS）during 0-3 postoperative hours

Time frame: during 0-3 postoperative hours

Secondary Outcomes

Postoperative pain at rest

The patients were instructed to give the number that represented the pain level at rest by using visual analogue scale（VAS）and prince-henry score

Time frame: At 1,3 postoperative hours

dosage Dosage of analgesics

Time frame: during 3 postoperative hours

Recovery time

Time frame: At the moment of the eyes opend when calling the names

Postoperative sedation

It was assessed by Ramsay Sedation Score(RSS)

Time frame: at 0,1,3 postoperative hours

Extubation time

Time frame: at the moment of extubation

Breathing recovery time

Time frame: when autonomous respiration recovered

Data from ClinicalTrials.gov

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