Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, R.O.C.
Division of General Surgery, Department of Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, R.O.C.
Int J Clin Pract. 2021 May;75(5):e14002. doi: 10.1111/ijcp.14002. Epub 2021 Jan 21.
Open living donor hepatectomy (OLDH) is a highly painful procedure. Advanced strategies for enhancing perioperative analgesia and accelerating recovery are needed for patients undergoing OLDH. This study evaluated the effects of intravenous infusion of dexmedetomidine (DEX) during OLDH on postoperative analgesia and recovery.
This prospective, randomised, double-blinded, and placebo-controlled study included 34 patients randomised to a control group (group C) and a DEX group (group D). Utilisation of intravenous patient-controlled analgesia (IV-PCA) pump, pain intensity, and postoperative recovery variables were recorded. Moreover, intraoperative anaesthetic consumption, hemodynamic parameters, and fluid status were also recorded.
During the first 24 hours after surgery, patients in group D had a lower pain intensity. The cumulative numbers of IV-PCA pump presses and fentanyl consumption within 24 and 48 hours postoperatively in group C were significantly higher than in group D. The time to first IV-PCA attempt was prolonged in group D. In addition, faster flatus passage was observed in group D. Intraoperatively, fewer anaesthetic agents were required in group D. Less fluctuation in hemodynamics and reduced bleeding were also found in group D.
The present study revealed that the addition of intravenous infusion of DEX during OLDH provided several benefits in relieving postoperative pain and promoting recovery. Therefore, we concluded that intraoperative DEX infusion may play an important role in enhancing the recovery of patients undergoing OLDH.
开放性活体肝切除术（OLDH）是一种非常痛苦的手术。需要为接受 OLDH 的患者提供先进的策略来增强围手术期镇痛和加速康复。本研究评估了在 OLDH 期间静脉输注右美托咪定（DEX）对术后镇痛和恢复的影响。
这是一项前瞻性、随机、双盲、安慰剂对照研究，纳入了 34 名随机分为对照组（C 组）和 DEX 组（D 组）的患者。记录静脉患者自控镇痛（IV-PCA）泵的使用、疼痛强度和术后恢复变量。此外，还记录了术中麻醉消耗、血液动力学参数和液体状态。
术后 24 小时内，D 组患者疼痛强度较低。C 组患者术后 24 小时和 48 小时内 IV-PCA 泵按压次数和芬太尼消耗量明显高于 D 组。D 组首次 IV-PCA 尝试的时间延长。此外，D 组更快地排气。术中 D 组需要的麻醉剂较少。D 组的血液动力学波动较小，出血减少。
本研究表明，在 OLDH 期间静脉输注 DEX 可提供多种缓解术后疼痛和促进康复的益处。因此，我们得出结论，术中 DEX 输注可能在促进接受 OLDH 的患者康复方面发挥重要作用。
