Kurçaloğlu Mustafa, Uzun Uslu Pinar, Yilmazlar Firdevs, Jabbarli Aygun, Uzuner Bora, Özkan Fatih, Güldoğuş Fuat
Department of Anesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Pain Clinic.
Necip Fazil State Hospital, Pain Clinic, Kahramanmaraş, Turkey.
Clin J Pain. 2025 Aug 1;41(8):e1298. doi: 10.1097/AJP.0000000000001298.
Lumbar facet radiofrequency ablation (LFRA) is a painful procedure. Sedation may be applied to improve patient comfort during the procedure; however, deep sedation should be avoided to maintain the patient cooperation. The purpose of this study was to compare dexmedetomidine and midazolam in sedoanalgesia for LFRA.
Patients planning to undergo LFRA were included in this cross-sectional, observational study. After a bolus dose, intravenous infusion of dexmedetomidine was administered in group D, whereas intravenous midazolam was given in group M. Intraoperative vital signs, procedural pain severity (Numerical Rating Scale-NRS), Patient Satisfaction Score (PSS), Operator Satisfaction Score (OSS), and complications were recorded.
A total of 96 patients were included in the study. Group D consisted of 47 and group M of 49 patients. Procedural NRS, PSS, and OSS were significantly in favor of group D. Mean procedural NRS of group D was 2.91±2.03, and 4.14±2.17 in group M ( P =0.005). The rate of unsatisfactory PSS was 1 (2.1%) in group D and 7 (20%) in group M ( P =0.03). The rate of unsatisfactory OSS results was 2 (4.2%) in group D and 16 (32.6%) in group M ( P <0.001). Although over-sedation and low oxygen saturation were significantly more frequent in group M, hypotension was higher in group D.
In sedoanalgesia for LFRA, dexmedetomidine is superior to midazolam with lower procedural pain, higher satisfaction scores, and improved patient cooperation. The results of this study can be considered for sedoanalgesia in other interventional pain procedures.
腰椎小关节射频消融术（LFRA）是一种有创操作。可应用镇静来提高患者术中舒适度；然而，应避免深度镇静以保持患者配合。本研究的目的是比较右美托咪定和咪达唑仑用于LFRA镇静镇痛的效果。
本横断面观察性研究纳入计划接受LFRA的患者。D组给予负荷剂量后静脉输注右美托咪定，M组静脉给予咪达唑仑。记录术中生命体征、手术疼痛严重程度（数字评分量表-NRS）、患者满意度评分（PSS）、术者满意度评分（OSS）及并发症。
本研究共纳入96例患者。D组47例，M组49例。手术NRS、PSS和OSS均显著有利于D组。D组手术平均NRS为2.91±2.03，M组为4.14±2.17（P =0.005）。D组PSS不满意率为1例（２.1%），M组为7例（20%）（P =0.03）。D组OSS结果不满意率为2例（4.2%），M组为16例（32.6%）（P <0.001）。虽然M组过度镇静和低氧饱和度明显更常见，但D组低血压发生率更高。
在LFRA镇静镇痛中，右美托咪定优于咪达唑仑，具有更低的手术疼痛、更高的满意度评分和更好的患者配合度。本研究结果可用于其他介入性疼痛治疗的镇静镇痛。
