Dexmedetomidine with sufentanil in intravenous patient-controlled analgesia for relief from postoperative pain, inflammation and delirium after esophageal cancer surgery.

Abstract

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.

• Authors: Chaoliang Tang, Yida Hu, Zhetao Zhang, Zeyuan Wei, Hongtao Wang, Qingtian Geng, Si Shi, Song Wang, Jiawu Wang, Xiaoqing Chai
• Journal: Bioscience reports (Biosci Rep) Vol. 40 Issue 5 (05 29 2020) ISSN: 1573-4935 [Electronic] England
• PMID: 32343308 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 The Author(s).

Chemical References

• Analgesics, Non-Narcotic
• Analgesics, Opioid
• Cytokines
• Inflammation Mediators
• Dexmedetomidine
• Sufentanil

Topics

• Administration, Intravenous
• Aged
• Analgesia, Patient-Controlled (adverse effects)
• Analgesics, Non-Narcotic (administration & dosage, adverse effects)
• Analgesics, Opioid (administration & dosage, adverse effects)
• China
• Cytokines (blood)
• Delirium (etiology, prevention & control)
• Dexmedetomidine (administration & dosage, adverse effects)
• Double-Blind Method
• Esophageal Neoplasms (surgery)
• Esophagectomy (adverse effects)
• Female
• Health Status
• Humans
• Inflammation (blood, etiology, prevention & control)
• Inflammation Mediators (blood)
• Laparoscopy (adverse effects)
• Male
• Middle Aged
• Pain, Postoperative (diagnosis, etiology, prevention & control)
• Prospective Studies
• Sufentanil (administration & dosage, adverse effects)
• Thoracoscopy (adverse effects)
• Time Factors
• Treatment Outcome