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Signa Vitae

Journal of Anaesthesia, Intensive Care and Emergency Medicine

The influence of dexmedetomidine on opioid consumption in radical prostatectomy

Abstract

Objective. Multimodal analgesia and analgesics with different modes of action can reduce perioperative opioid demand and their undesirable side effects.

In our study we presumed that patients anesthetised with additional perioperative dexmedetomidine infusion, during radical prostatectomy, would need less opioids during and after surgery compared to the control group.

Materials and methods. 40 patients, 18-80 years of age, ASA class 1-3 (American Society of Anesthesiologists), scheduled for radical prostatectomy, were included in the study. Patients were randomly divided into two groups (20 pts in each group). In both groups, fentanyl in repeated boluses was used as an analgesic; in the studied group, an additional infusion of dexmedetomidine (0.3 µg/kg/h) was started with intravenous line insertion and continued until the beginning of wound closure. Analgesic consumption during the operation, in the post-anaesthesia care unit, in the Intensive Care Unit on the day of the operation and on the first postoperative day was recorded.

Results. The patients with perioperative dexmedetomidine infusion were slightly younger (p=0.007), also the duration of their surgery was shorter (p =0.05). Differences in opioid consumption between the groups were not found. Also, pain assessment, by visual analogue scale (VAS) after 12, 18, 24, 30, 36 and 42 hours, was not statistically different between groups.

Conclusion. In our study, perioperative dexmadetomidine did not reduce peri- and postoperative opioid consumption. Also, undesirable dexmedetomidine side effects, such as bradycardia and hypotension, were not observed.

Key words: dexmedetomidine, radical prostatectomy

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Dexmedetomidine in abdominal and thoracic anesthesia

Background

The Bispectral Index (BIS) is a processed electroencephalographic parameter that correlates with the sedative-hypnotic actions of anaesthetic drugs. Dexmedetomidine and lidocaine have both opioid sparing effects. Their influence in laparoscopic surgery has not been studied yet. We investigated their effect on perioperative opioid consumption, cognitive function and incidence of neuropathic pain.

Keywords: bispectral index, dexmedetomidine, lidocaine

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Dexmedetomidine and Non-Intubated VATS – Our Experiences in University Medical Centre Ljubljana

Background

Non-intubated thoracic surgery has evolved since the early beginning of 21.century. In University Medical Centre Ljubljana we started with simple non-intubated procedures in October 2015. Many contributung factors are imperative for early start with good results. Surgical technique in VATS procedures has to be fully established. Anesthesiologist, involved in such procedures, has to be confident in thoracic anesthesia with emphasis on airway management. Good technical equipment is fundamental. On the other hand, patient have to be preciselly selected with writen informed conset.

Key words: non-intubated VATS, intercostal blockade, dexmedetomidine, bispectral index, videolaryngoscope

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