Abstract
BackgroundThere are no studies on the use of dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia (PCIA) in females undergoing thoracic surgery. We postulate that introducing dexmedetomidine to a combination of dezocine-based PCA drugs and sufentanil will increase female patients’ global satisfaction degree.MethodsOne hundred fifty-two female patients with physical classification type I or II according to the American Society of Anesthesiologists undergoing thoracoscopic surgery were arbitrarily classified into two categories, either receiving sufentanil and dezocine-based PCIA (group C) or incorporating dexmedetomidine with sufentanil and dezocine-based PCIA (group D). The patients’ global satisfaction degree, postoperative nausea and vomiting (PONV), PCA bolus, rescue analgesia requirements, drug-related adverse effects, rest and coughing visual analogue scale (VAS) ratings, and Ramsay sedation scores (RSS) were measured at 6, 12, 24, 36 and 48 h after surgery.ResultsCompared with the C group, the patient satisfaction degree was significantly higher; pain scores at rest and coughing were significantly different at 6, 12, 24, 36 and 48 h postoperatively; less rescue analgesia and PCA bolus were required; and a lower incidence of PONV was found in the D group. There were non-significant trends for the sedation scores and drug-related adverse effects in both groups.ConclusionsDexmedetomidine combined with sufentanil and dezocine increased female patients’ global satisfaction degree after thoracoscopic surgery. This effect could be linked to the improvement in postoperative analgesia and reduction in postoperative nausea and vomiting; the combined treatment did not increase drug-related adverse effects in female patients.Trial registrationChinese Clinical Trial Registry number, ChiCTR2000030429. Registered on March 1, 2020.
Highlights
With the emergence of enhanced recovery after surgery (ERAS), adequate pain control has been reported to enhance surgical results leading to decreased morbidity, hospitalisation and convalescence, and it is generally accepted that adequate pain management is a requirement for early postoperative rehabilitation [1]
There were no major variations between the demographic information of the groups (Table 1), namely, height, age, weight, American Society of Anesthesiologists (ASA) grade, operating period, intraoperative sufentanil and remifentanil intake, or right/left lobectomy resection (P > 0.05, Table 1)
In this randomised controlled study, dexmedetomidine introduced to a sufentanil and dezocine-based PCA drug blend increased female patients’ postoperative global satisfaction degree, reduced the severity and frequency of vomiting and nausea and the requirement for rescue analgesia, minimised the consumption of analgesic, and decreased postoperative pain scores without increasing the incidence of clinically relevant hypertension, hypotension, excessive sedation, sinus bradycardia, hypoxaemia or respiratory depression during the first 48 h after thoracoscopy
Summary
With the emergence of enhanced recovery after surgery (ERAS), adequate pain control has been reported to enhance surgical results leading to decreased morbidity, hospitalisation and convalescence, and it is generally accepted that adequate pain management is a requirement for early postoperative rehabilitation [1]. Patients undergoing thoracic surgery experience serious pain with major effects from respiratory movements during the postoperative period [2, 3]. The most widely used analgesic approach continues to be patient-controlled intravenous analgesia (PCIA). While increased dosages of opioid pharmaceutical products may improve postoperative pain, undesirable drug-related consequences, including pruritus, vomiting, nausea and respiratory distress, often occur, especially for female patients [4, 5]. Small doses of dezocine combined with morphine increase the effectiveness of postoperative analgesia for thoracotomy [7]. There are no studies on the use of dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia (PCIA) in females undergoing thoracic surgery. We postulate that introducing dexmedetomidine to a combination of dezocine-based PCA drugs and sufentanil will increase female patients’ global satisfaction degree
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