Effects of dexmedetomidine on postoperative pain, perioperative opioid consumption and hemodynamics in supratentorial craniotomies: Observational study

Öz

Objective: The present study aimed to observe the effects of two different doses of dexmedetomidine infusion in supratentorial craniotomies on intraoperative hemodynamics, inhaled anesthetic, and perioperative opioid consumption. The study also examines whether the method reduces adverse events such as postoperative pain and nausea/vomiting. Methods: Ninety patients aged between 18 and 70 classified as American Society of Anesthesiologists class I–II who underwent supratentorial craniotomy under elective conditions and who received dexmedetomidine infusion (0.2 and 0.4 μg.kg−1h−1 ) or not were observed. Intraoperative hemodynamic data, remifentanil and sevoflurane consumption, postoperative pain and nausea/vomiting scores, and total opioid consumption were evaluated. Results: Hemodynamic data of the patients were similar. Sevoflurane consumption intraoperatively and opioid consumption both intraoperatively and postoperatively decreased significantly in the patients receiving dexmedetomidine infusion (p < 0.001). The pain and nausea/vomiting scores were similar in the postoperative period. Conclusion: Dexmedetomidine infusion during general anesthesia for supratentorial craniotomies reduces inhaled anesthetic and perioperative opioid consumption without causing any hemodynamic side effects.

Anahtar Kelimeler

• Neuroanesthesia
• dexmedetomidine
• perioperative care
• postoperative analgesia
• postoperative nausea and vomiting

Supratentorial kraniotomilerde deksmedetomidinin postoperatif ağrı, perioperatif opioid tüketimi ve hemodinami üzerine etkileri: Gözlemsel çalışma

Öz

Amaç: Bu çalışma, supratentoryal kraniotomi operasyonlarında uygulanan iki farklı dozda deksmedetomidin infüzyonunun intraoperatif hemodinami, inhalasyon anesteziği ve perioperatif opioid tüketimi üzerindeki etkilerini gözlemlemeyi amaçlamıştır. Ayrıca yöntemin postoperatif ağrı ve bulantı/kusma gibi istenmeyen olayları azaltıp azaltmadığı da değerlendirilmiştir. Yöntemler: Elektif koşullarda supratentoryal kraniotomi uygulanan, Amerikan Anesteziyologlar Derneği (ASA) sınıf I–II olarak değerlendirilen 18–70 yaş arası toplam 90 hasta incelenmiştir. Hastalar, deksmedetomidin infüzyonu alan (0.2 ve 0.4 μg·kg⁻¹·saat⁻¹) ve almayan gruplar olarak gözlemlenmiştir. İntraoperatif hemodinamik veriler, remifentanil ve sevofluran tüketimi, postoperatif ağrı ve bulantı/kusma skorları ile toplam opioid tüketimi değerlendirilmiştir. Bulgular: Hastaların hemodinamik verileri benzer bulunmuştur. Deksmedetomidin infüzyonu uygulanan hastalarda intraoperatif sevofluran tüketimi ile intraoperatif ve postoperatif opioid tüketimi anlamlı olarak azalmıştır (p < 0.001). Postoperatif dönemde ağrı ve bulantı/kusma skorları bakımından gruplar arasında anlamlı fark saptanmamıştır. Sonuç: Supratentoryal kraniotomilerde genel anestezi sırasında uygulanan deksmedetomidin infüzyonu, herhangi bir hemodinamik yan etki oluşturmaksızın inhalasyon anesteziği ve perioperatif opioid tüketimini azaltmaktadır.

Anahtar Kelimeler

• Nöroanestezi
• deksmedetomidin
• perioperatif bakım
• postoperatif analjezi
• postoperatif bulantı ve kusma.

Kaynakça

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