Khanahmad Negar, Rahimi Zahra, Masoudifar Mehrdad, Nazemroaya Behzad
Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2023 Jan 27;12:2. doi: 10.4103/abr.abr_303_21. eCollection 2023.
Considering the preventative effect of various medications on such complications after surgery, the present study evaluated the effect of two different dexmedetomidine doses on the prevention of nausea and vomiting in discectomy surgery.
The present controlled, double-blind clinical trial was performed on 135 patients that were candidates for discectomy surgery under spinal anesthesia, which were randomly allocated into three groups. Two different dexmedetomidine doses of 0.2 and 0.5 mcg/kg/h were intravenously administered using an infusion pump for 10 min in the first (DEX-0.2 group) and second (DEX-0.5 group) groups, respectively, with the third placebo group being used as a control group. Hemodynamic parameters, the severity of nausea and vomiting, and the incidence of complications were evaluated and recorded up to 24 h after surgery.
The results of the present study revealed that, 20 min after the intervention, the severity of nausea and vomiting in the control group (with the mean of 1.95 ± 1.58) was significantly higher than that of the DEX-0.2 and DEX-0.5 groups with the means of 1.52 ± 1.11 and 1.27 ± 0.99, respectively ( = 0.010). In addition, no significant difference was found between the two dexmedetomidine doses in terms of the severity of nausea and vomiting ( > 0.05).
According to the results of the present study, a low dose of dexmedetomidine may be a more preferable choice as a preventive drug in the incidence of nausea and vomiting in discectomy surgery due to its lower complications, further reduction of nausea and vomiting, and more desirable hemodynamic stability.
考虑到各种药物对术后此类并发症的预防作用,本研究评估了两种不同剂量右美托咪定对椎间盘切除术恶心呕吐的预防效果。
本对照双盲临床试验对135例拟行脊髓麻醉下椎间盘切除术的患者进行,将其随机分为三组。第一组(DEX - 0.2组)和第二组(DEX - 0.5组)分别使用输液泵静脉注射两种不同剂量的右美托咪定,剂量分别为0.2和0.5 mcg/kg/h,持续10分钟,第三组为安慰剂对照组。评估并记录术后24小时内的血流动力学参数、恶心呕吐严重程度及并发症发生率。
本研究结果显示,干预后20分钟,对照组恶心呕吐严重程度(均值为1.95±1.58)显著高于DEX - 0.2组(均值为1.52±1.11)和DEX - 0.5组(均值为1.27±0.99)(P = 0.010)。此外,两种右美托咪定剂量在恶心呕吐严重程度方面无显著差异(P>0.05)。
根据本研究结果,低剂量右美托咪定可能是椎间盘切除术恶心呕吐预防药物的更优选择,因其并发症较少、能进一步减轻恶心呕吐且血流动力学稳定性更佳。