Lopez Mariela M, Zech Derrick, Linton Judith L, Blackwell Steven J
1 Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX, USA.
2 Department of Oral and Maxillofacial Surgery, Health Science Center, University of Texas Houston, Houston, TX, USA.
Cleft Palate Craniofac J. 2018 May;55(5):688-691. doi: 10.1177/1055665618754949. Epub 2018 Feb 15.
Dexmedetomidine is a parenteral agent that combines the benefits of cooperative sedation, anxiolysis, and analgesia without the risks of respiratory depression. Off-label use has been reported in children. We have introduced dexmedetomidine for use in patients having undergone alveolar bone graft (ABG). The objective is to demonstrate the value and safety of postoperative dexmedetomidine infusion in a non-ICU setting following ABG.
A retrospective review was performed on patients who underwent ABG by the senior author. Patients were divided into 2 groups: those who received postoperative dexmedetomidine and those who received patient-controlled anesthesia.
MAIN OUTCOME MEASURE(S): The primary study outcome measures included patient demographics, adverse events, length of stay, pain scores, and doses of narcotics during admission were collected.
Inclusion criteria were met by 54 patients; 39 received dexmedetomidine whereas 15 did not. There were no significant differences between groups in age, gender, and length of stay. The patients who received dexmedetomidine used oral narcotics less often ( P = .01). In addition, more patients reported no pain after surgery ( P = .05) and at the time of discharge if they received dexmedetomidine ( P < .01). There were no reported adverse effects.
Dexmedetomidine provided superior pain control after surgery and at the time of discharge, as well as a significant decrease in the use of oral narcotics. In our institution, it has since replaced the PCA as a postoperative pain control modality. Absent the risk for respiratory depression, dexmedetomidine has demonstrated a safe option for postoperative pain control in our focused group of pediatric patients.
右美托咪定是一种胃肠外给药制剂，兼具协同镇静、抗焦虑和镇痛作用，且无呼吸抑制风险。儿童中已有其超说明书用药的报道。我们已将右美托咪定用于接受牙槽骨移植（ABG）的患者。目的是证明在ABG术后非重症监护病房环境中输注右美托咪定的价值和安全性。
对资深作者实施ABG手术的患者进行回顾性研究。患者分为两组：术后接受右美托咪定治疗的患者和接受自控镇痛的患者。
收集主要研究观察指标，包括患者人口统计学资料、不良事件、住院时间、疼痛评分以及入院期间的麻醉药品剂量。
54例患者符合纳入标准；39例接受右美托咪定治疗，15例未接受。两组在年龄、性别和住院时间方面无显著差异。接受右美托咪定治疗的患者较少使用口服麻醉药品（P = 0.01）。此外，更多接受右美托咪定治疗的患者术后（P = 0.05）及出院时（P < 0.01）报告无疼痛。未报告有不良反应。
右美托咪定在术后及出院时提供了更好的疼痛控制，同时口服麻醉药品的使用显著减少。在我们机构，它已取代自控镇痛成为术后疼痛控制方式。由于没有呼吸抑制风险，右美托咪定已证明是我们特定儿科患者群体术后疼痛控制的安全选择。
