Dexmedetomidine with sufentanil in intravenous patient-controlled analgesia for relief from postoperative pain, inflammation and delirium after esophageal cancer surgery
© 2020 The Author(s)..
BACKGROUND AND AIMS: Postoperative pain can cause serious adverse reactions that severely affect postoperative outcome. The present study evaluated the effect of dexmedetomidine (DEX) added to sufentanil in intravenous patient-controlled analgesia (PCA) on the relief of pain and inflammatory responses during postoperative recovery of patients undergoing a combined thoracoscopic-laparoscopic esophagectomy (TLE).
METHODS: Sixty patients undergoing TLE were randomly allocated to receive 1 μg/ml of sufentanil alone (Group S) or 1 μg/ml of sufentanil plus 2.5 μg/ml of DEX (Group D) for postoperative intravenous (IV) PCA. Postoperative pain relief, cumulative PCA requirements, inflammatory marker levels, delirium and recovery were assessed.
RESULTS: A joint DEX and sufentanil regimen significantly reduced the area under the curve of numerical rating scores for pain at rest (NRSR) and coughing (NRSC) at 1-48 h postoperatively (P = 0.000) that were associated with lower PCA-delivered cumulative sufentanil consumption and less PCA frequency until 48 h postoperatively (P < 0.05 and P < 0.0001, respectively). The simultaneous administration of DEX and sufentanil significantly reduced plasma IL-6 and TNF-α concentrations and increased IL-10 level (P < 0.0001, P = 0.0003 and P = 0.0345, respectively), accompanied by better postoperative delirium categories and health statuses of patients (P = 0.024 and P < 0.05, respectively). There was no hypotension, bradycardia, respiratory depression or oversedation in Group D.
CONCLUSION: Patients receiving DEX in addition to IV PCA sufentanil for TLE exhibited better postoperative analgesia, fewer inflammatory responses and lower postoperative delirium categories and better health statuses.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
Bioscience reports - 40(2020), 5 vom: 29. Mai |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tang, Chaoliang [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 23.03.2021 Date Revised 23.03.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1042/BSR20193410 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM309273110 |
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| 245 | 1 | 0 | |a Dexmedetomidine with sufentanil in intravenous patient-controlled analgesia for relief from postoperative pain, inflammation and delirium after esophageal cancer surgery |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Completed 23.03.2021 | ||
| 500 | |a Date Revised 23.03.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The Author(s). | ||
| 520 | |a BACKGROUND AND AIMS: Postoperative pain can cause serious adverse reactions that severely affect postoperative outcome. The present study evaluated the effect of dexmedetomidine (DEX) added to sufentanil in intravenous patient-controlled analgesia (PCA) on the relief of pain and inflammatory responses during postoperative recovery of patients undergoing a combined thoracoscopic-laparoscopic esophagectomy (TLE) | ||
| 520 | |a METHODS: Sixty patients undergoing TLE were randomly allocated to receive 1 μg/ml of sufentanil alone (Group S) or 1 μg/ml of sufentanil plus 2.5 μg/ml of DEX (Group D) for postoperative intravenous (IV) PCA. Postoperative pain relief, cumulative PCA requirements, inflammatory marker levels, delirium and recovery were assessed | ||
| 520 | |a RESULTS: A joint DEX and sufentanil regimen significantly reduced the area under the curve of numerical rating scores for pain at rest (NRSR) and coughing (NRSC) at 1-48 h postoperatively (P = 0.000) that were associated with lower PCA-delivered cumulative sufentanil consumption and less PCA frequency until 48 h postoperatively (P < 0.05 and P < 0.0001, respectively). The simultaneous administration of DEX and sufentanil significantly reduced plasma IL-6 and TNF-α concentrations and increased IL-10 level (P < 0.0001, P = 0.0003 and P = 0.0345, respectively), accompanied by better postoperative delirium categories and health statuses of patients (P = 0.024 and P < 0.05, respectively). There was no hypotension, bradycardia, respiratory depression or oversedation in Group D | ||
| 520 | |a CONCLUSION: Patients receiving DEX in addition to IV PCA sufentanil for TLE exhibited better postoperative analgesia, fewer inflammatory responses and lower postoperative delirium categories and better health statuses | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Dexmedetomidine | |
| 650 | 4 | |a delirium | |
| 650 | 4 | |a inflammatory response | |
| 650 | 4 | |a patient-controlled analgesia | |
| 650 | 4 | |a postoperative pain | |
| 650 | 4 | |a thoracoscopic-laparoscopic esophagectomy | |
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| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 650 | 7 | |a Cytokines |2 NLM | |
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| 700 | 1 | |a Wang, Hongtao |e verfasserin |4 aut | |
| 700 | 1 | |a Geng, Qingtian |e verfasserin |4 aut | |
| 700 | 1 | |a Shi, Si |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Song |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jiawu |e verfasserin |4 aut | |
| 700 | 1 | |a Chai, Xiaoqing |e verfasserin |4 aut | |
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