Effects of Dexmedetomidine On the Postoperative Shivering, Nausea, and Vomiting Among Opium User Patients Undergoing Elective Supratentorial Brain Tumor Surgery: A Randomized, Placebo, Controlled Clinical trials.

Mona Rajabi,Davood Ommi,Noor Mohammad Arefian,Alireza Zali

doi:10.31661/gmj.v10i0.2146

Abstract

Postoperative nausea and vomiting (PONV) and shivering are common general anesthesia complications. Hence, this study evaluates the effect of dexmedetomidine, given as a premedication, on PONV and shivering in patients with opium use who underwent elective supratentorial brain tumor surgeries. In a randomized clinical trial, 100 opium user patients who were candidates for elective supra-tentorial brain tumor surgery under general anesthesia were studied in two groups of 50 patients. The intervention group received dexmedetomidine (within 10 minutes infusion) 30 minutes before the anesthesia induction. Group placebo that received normal saline as a group. PONV and shivering rates were compared between the two groups. Both groups did not differ in hemodynamic parameters during operation, including pulse rate, systolic and diastolic blood pressure, and anesthesia duration. In the dexmedetomidine group, patients suffered less from PONV and shivering rather than controls, and these differences were both significant (P=0.001 and P=0.027, respectively). Dexmedetomidine administration before major surgeries might reduce post-operative nausea and vomiting and the occurrence of shivering, particularly in opium-addicted patients.

Highlights

General anesthesia is used in many surgeries, followed by several complications, including nausea, vomiting, shivering, and hemodynamic instability [1]
The present study was conducted to evaluate the effect of dexmedetomidine, given as a premedication, on Postoperative nausea and vomiting (PONV) and shivering among patients with opium use who underwent elective supratentorial brain tumor surgeries
The present study showed that perioperative infusion of dexmedetomidine reduced shiv

Summary

Introduction

General anesthesia is used in many surgeries, followed by several complications, including nausea, vomiting, shivering, and hemodynamic instability [1]. PONV may lead to more serious difficulties such as aspiration and suture dehiscence [6] It causes electrolyte disturbances, worsening bleeding, prolonged recovery, and hospitalization in patients [7]. Dexmedetomidine is a highly a2-adrenoreceptor agonist that binds to the transmembrane G-protein receptor and has no effect on the gamma-aminobutyric acid system [11, 12]. It has sedative, analgesic, sympatholytic, and amnestic properties [13] that increase the shivering threshold in patients [14]. Patients with opium use are more prone to postoperative complications and exhibit tolerance to many drugs; anesthesia management in this group is a significant concern for anesthesiologists. The present study was conducted to evaluate the effect of dexmedetomidine, given as a premedication, on PONV and shivering among patients with opium use who underwent elective supratentorial brain tumor surgeries

Materials and Methods

Results

Discussion

Conclusion