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Original Research

Open Access Special Issue

Dexmedetomidine versus fentanyl on stress response and pain control in adult patients undergoing laparoscopic surgery

  • Marian Greiss1
  • Bassem Boulos Ghobrial2
  • Waleed Mohamed Abd Elmageed2
  • Dalia Mahmoud Elfawy2
  • Raham Hasan Mostafa2

1Anesthesia Department, Sahel Teaching Hospital, 11697 Cairo, Egypt

2Department of Anesthesia & Intensive Care & Pain Management, Faculty of Medicine, Ain Shams University, 11591 Cairo, Egypt

DOI: 10.22514/sv.2022.007

Submitted: 01 October 2021 Accepted: 14 December 2021

Online publish date: 20 January 2022

(This article belongs to the Special Issue Opioid Free Analgesia: new concept, new trends)

*Corresponding Author(s): Marian Greiss E-mail: mariangreiss@outlook.com

Abstract

Laparoscopic procedures are widely indicated; however, the ideal approach for pain control remains debatable. This trial compared between the effects of dexmedetomidine and fentanyl infusion on stress response and pain control in patients undergoing elective laparoscopic surgeries. A prospective randomized double-blinded comparative study included 82 adult participants randomly allocated into two equal-sized groups. Group D received 1 µg/kg of intravenous (IV) dexmedetomidine over 10 min as a loading dose just before induction of anesthesia, then 0.2–0.7 µg/kg/h till 10 min before the surgery ends. Group F received 1 µg/kg of IV fentanyl as a loading dose, then 0.2–0.7 µg/kg/h. Primary objective was postoperative analgesic consumption in 24 h. Collected data were heart rate (HR), mean arterial blood pressure (MAP), blood glucose and serum cortisol levels, visual analogue score (VAS), and the perioperative analgesic consumption. Group D consumed significantly less postoperative morphine doses in 24 h (p = 0.003), and 41.5% of Group D patients did not need any postoperative morphine. Group D had better-controlled hemodynamic changes 5 min post-extubation (HR and MAP p = 0.021 and p = 0.022 respectively), showed significantly less postoperative stress response as manifested in the blood glucose and serum cortisol levels 4 h postoperatively (p = 0.006 and p = 0.001 respectively), and less VAS pain scores at early and late postoperative periods. Intraoperative IV dexmedetomidine administration as a sole analgesic agent for patients undergoing elective laparoscopic surgeries serves as a convenient anesthetic approach, since it provided a good postoperative pain control, and reduced the surgical stress response and the perioperative analgesic consumption.


Keywords

Dexmedetomidine; Laparoscopic surgery; Postoperative pain; Stress response; VAS score; Opioid-free anesthesia


Cite and Share

Marian Greiss,Bassem Boulos Ghobrial,Waleed Mohamed Abd Elmageed,Dalia Mahmoud Elfawy,Raham Hasan Mostafa. Dexmedetomidine versus fentanyl on stress response and pain control in adult patients undergoing laparoscopic surgery. Signa Vitae. 2022.doi:10.22514/sv.2022.007.

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