Cargando…

Effect of Intraoperative Sedation with Dexmedetomidine Versus Propofol on Acute Postoperative Pain Following Major Foot Surgery under Popliteal Sciatic Nerve Block: A Randomized Controlled Trial

Intravenous (IV) dexmedetomidine is reported to prolong analgesia following peripheral nerve blocks. Popliteal sciatic nerve block provides effective postoperative analgesia, but some patients still experience severe pain during the early postoperative period. We aimed to evaluate the postoperative...

Descripción completa

Detalles Bibliográficos
Autores principales: Kang, RyungA, Choi, Ji Won, Sung, Ki-Sun, Wi, Wongook, Hahm, Tae Soo, Cho, Hyun Sung, Yang, Mi Kyung, Ko, Justin Sangwook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141289/
https://www.ncbi.nlm.nih.gov/pubmed/32121242
http://dx.doi.org/10.3390/jcm9030654
_version_ 1783519165184737280
author Kang, RyungA
Choi, Ji Won
Sung, Ki-Sun
Wi, Wongook
Hahm, Tae Soo
Cho, Hyun Sung
Yang, Mi Kyung
Ko, Justin Sangwook
author_facet Kang, RyungA
Choi, Ji Won
Sung, Ki-Sun
Wi, Wongook
Hahm, Tae Soo
Cho, Hyun Sung
Yang, Mi Kyung
Ko, Justin Sangwook
author_sort Kang, RyungA
collection PubMed
description Intravenous (IV) dexmedetomidine is reported to prolong analgesia following peripheral nerve blocks. Popliteal sciatic nerve block provides effective postoperative analgesia, but some patients still experience severe pain during the early postoperative period. We aimed to evaluate the postoperative analgesic effects of IV dexmedetomidine versus propofol in patients undergoing foot surgeries under popliteal sciatic nerve block. Forty patients were enrolled and randomly assigned to receive either IV propofol (n = 20) or IV dexmedetomidine (n = 20) for intraoperative sedation. All the patients received continuous popliteal sciatic nerve block. The corresponding drug infusion rate was adjusted to achieve a modified observer’s assessment of alertness/sedation score of 3 or 4. The primary outcome was postoperative cumulative opioid consumption during the first 24 h after surgery. Thirty-nine patients were analyzed. The median (interquartile ranges) postoperative cumulative opioid consumption during the first 24 h after surgery was significantly lower in the dexmedetomidine group (15 (7.5–16.9) mg) than in the propofol group (17.5 (15–25) mg) (p = 0.019). The time to first rescue analgesic request was significantly greater in the dexmedetomidine group than in the propofol group (11.8 ± 2.2 h vs. 10.0 ± 2.7 h, p = 0.030) without the prolonged motor blockade (p = 0.321). Intraoperative sedation with dexmedetomidine reduced postoperative opioid consumption and prolonged analgesic duration after a popliteal sciatic nerve block.
format Online
Article
Text
id pubmed-7141289
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-71412892020-04-10 Effect of Intraoperative Sedation with Dexmedetomidine Versus Propofol on Acute Postoperative Pain Following Major Foot Surgery under Popliteal Sciatic Nerve Block: A Randomized Controlled Trial Kang, RyungA Choi, Ji Won Sung, Ki-Sun Wi, Wongook Hahm, Tae Soo Cho, Hyun Sung Yang, Mi Kyung Ko, Justin Sangwook J Clin Med Article Intravenous (IV) dexmedetomidine is reported to prolong analgesia following peripheral nerve blocks. Popliteal sciatic nerve block provides effective postoperative analgesia, but some patients still experience severe pain during the early postoperative period. We aimed to evaluate the postoperative analgesic effects of IV dexmedetomidine versus propofol in patients undergoing foot surgeries under popliteal sciatic nerve block. Forty patients were enrolled and randomly assigned to receive either IV propofol (n = 20) or IV dexmedetomidine (n = 20) for intraoperative sedation. All the patients received continuous popliteal sciatic nerve block. The corresponding drug infusion rate was adjusted to achieve a modified observer’s assessment of alertness/sedation score of 3 or 4. The primary outcome was postoperative cumulative opioid consumption during the first 24 h after surgery. Thirty-nine patients were analyzed. The median (interquartile ranges) postoperative cumulative opioid consumption during the first 24 h after surgery was significantly lower in the dexmedetomidine group (15 (7.5–16.9) mg) than in the propofol group (17.5 (15–25) mg) (p = 0.019). The time to first rescue analgesic request was significantly greater in the dexmedetomidine group than in the propofol group (11.8 ± 2.2 h vs. 10.0 ± 2.7 h, p = 0.030) without the prolonged motor blockade (p = 0.321). Intraoperative sedation with dexmedetomidine reduced postoperative opioid consumption and prolonged analgesic duration after a popliteal sciatic nerve block. MDPI 2020-02-28 /pmc/articles/PMC7141289/ /pubmed/32121242 http://dx.doi.org/10.3390/jcm9030654 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kang, RyungA
Choi, Ji Won
Sung, Ki-Sun
Wi, Wongook
Hahm, Tae Soo
Cho, Hyun Sung
Yang, Mi Kyung
Ko, Justin Sangwook
Effect of Intraoperative Sedation with Dexmedetomidine Versus Propofol on Acute Postoperative Pain Following Major Foot Surgery under Popliteal Sciatic Nerve Block: A Randomized Controlled Trial
title Effect of Intraoperative Sedation with Dexmedetomidine Versus Propofol on Acute Postoperative Pain Following Major Foot Surgery under Popliteal Sciatic Nerve Block: A Randomized Controlled Trial
title_full Effect of Intraoperative Sedation with Dexmedetomidine Versus Propofol on Acute Postoperative Pain Following Major Foot Surgery under Popliteal Sciatic Nerve Block: A Randomized Controlled Trial
title_fullStr Effect of Intraoperative Sedation with Dexmedetomidine Versus Propofol on Acute Postoperative Pain Following Major Foot Surgery under Popliteal Sciatic Nerve Block: A Randomized Controlled Trial
title_full_unstemmed Effect of Intraoperative Sedation with Dexmedetomidine Versus Propofol on Acute Postoperative Pain Following Major Foot Surgery under Popliteal Sciatic Nerve Block: A Randomized Controlled Trial
title_short Effect of Intraoperative Sedation with Dexmedetomidine Versus Propofol on Acute Postoperative Pain Following Major Foot Surgery under Popliteal Sciatic Nerve Block: A Randomized Controlled Trial
title_sort effect of intraoperative sedation with dexmedetomidine versus propofol on acute postoperative pain following major foot surgery under popliteal sciatic nerve block: a randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141289/
https://www.ncbi.nlm.nih.gov/pubmed/32121242
http://dx.doi.org/10.3390/jcm9030654
work_keys_str_mv AT kangryunga effectofintraoperativesedationwithdexmedetomidineversuspropofolonacutepostoperativepainfollowingmajorfootsurgeryunderpoplitealsciaticnerveblockarandomizedcontrolledtrial
AT choijiwon effectofintraoperativesedationwithdexmedetomidineversuspropofolonacutepostoperativepainfollowingmajorfootsurgeryunderpoplitealsciaticnerveblockarandomizedcontrolledtrial
AT sungkisun effectofintraoperativesedationwithdexmedetomidineversuspropofolonacutepostoperativepainfollowingmajorfootsurgeryunderpoplitealsciaticnerveblockarandomizedcontrolledtrial
AT wiwongook effectofintraoperativesedationwithdexmedetomidineversuspropofolonacutepostoperativepainfollowingmajorfootsurgeryunderpoplitealsciaticnerveblockarandomizedcontrolledtrial
AT hahmtaesoo effectofintraoperativesedationwithdexmedetomidineversuspropofolonacutepostoperativepainfollowingmajorfootsurgeryunderpoplitealsciaticnerveblockarandomizedcontrolledtrial
AT chohyunsung effectofintraoperativesedationwithdexmedetomidineversuspropofolonacutepostoperativepainfollowingmajorfootsurgeryunderpoplitealsciaticnerveblockarandomizedcontrolledtrial
AT yangmikyung effectofintraoperativesedationwithdexmedetomidineversuspropofolonacutepostoperativepainfollowingmajorfootsurgeryunderpoplitealsciaticnerveblockarandomizedcontrolledtrial
AT kojustinsangwook effectofintraoperativesedationwithdexmedetomidineversuspropofolonacutepostoperativepainfollowingmajorfootsurgeryunderpoplitealsciaticnerveblockarandomizedcontrolledtrial