Entezary Saeid-Reza, Faiz Seyed Hamid Reza, Alebouyeh Mahmood-Reza, Sharifian Anoushiravan, Derakhshan Pooya
School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Anesthesiology and Pain Fellowship, Rasoul Akram Medical Center, Tehran, Iran.
Anesth Pain Med. 2023 Mar 5;13(1):e134842. doi: 10.5812/aapm-134842. eCollection 2023 Feb.
The unique analgesic properties of dexmedetomidine have led anesthesiologists to use it as an alternative to relieve pain after major surgeries.
We aimed to evaluate the effect of continuous injection of thoracic epidural dexmedetomidine on analgesia after thoracotomy.
In this randomized, double-blind clinical trial, 46 patients (18 to 70 years old) who were candidates for thoracotomy surgery were randomly assigned to receive ropivacaine alone or combined with dexmedetomidine after epidural anesthesia as postoperative epidural anesthesia. The postoperative sedation rate, pain score, and opioid use were assessed within 48 hours after surgery and compared between the 2 groups.
Comparing the mean postoperative sedation scores indicated no difference between the 2 study groups. The pain score assessment showed a lower pain score 6 to 36 hours after surgery in the group receiving concurrent ropivacaine and dexmedetomidine than in the group receiving ropivacaine alone. In the 2 groups receiving ropivacaine with and without dexmedetomidine, the rate of morphine administration after surgery was 43.4% and 65.2%, respectively, indicating no difference. However, the first group received significantly lower doses of morphine after the end of surgery (3.26 ± 0.90 mg vs. 7.04 ± 1.48 mg; P = 0.035).
A combination of ropivacaine and dexmedetomidine as epidural analgesia can lead to lower postoperative pain scores and reduced doses of opioids required.
右美托咪定独特的镇痛特性促使麻醉医生将其用作大手术后缓解疼痛的替代药物。
我们旨在评估持续输注胸段硬膜外右美托咪定对开胸术后镇痛的效果。
在这项随机、双盲临床试验中，46例（年龄18至70岁）拟行开胸手术的患者在硬膜外麻醉后被随机分配，分别接受单纯罗哌卡因或罗哌卡因联合右美托咪定作为术后硬膜外镇痛。术后48小时内评估术后镇静率、疼痛评分和阿片类药物使用情况，并在两组间进行比较。
比较两组术后平均镇静评分，显示无差异。疼痛评分评估表明，术后6至36小时，同时接受罗哌卡因和右美托咪定的组比单纯接受罗哌卡因的组疼痛评分更低。在接受罗哌卡因加或不加右美托咪定的两组中，术后吗啡给药率分别为43.4%和65.2%，表明无差异。然而，第一组在手术结束后接受的吗啡剂量显著更低（3.26±0.90毫克对7.04±1.48毫克；P=0.035）。
罗哌卡因和右美托咪定联合用于硬膜外镇痛可降低术后疼痛评分并减少所需阿片类药物剂量。
