Efficacy of dexmedetomidine mixed with sufentanil for patient-controlled intravenous analgesia in patients undergoing transcatheter hepatic arterial chemoembolization

Abstract

Objective To evaluate the efficacy of dexmedetomidine mixed with sufentanil for patient-controlled intravenous analgesia(PCIA)in the patients undergoing transcatheter hepatic arterial chemoembolization(TACE). Methods One hundred and twenty patients of both sexes, aged 40-65 yr, weighing 45-80 kg, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective TACE under monitored anesthesia care, were divided into 2 groups(n=60 each)using a random number table: sufentanil group(S group)and dexmedetomidine mixed with sufentanil group(DS group). At 15 min prior to surgery, 0.1 μg/kg sufentanil and 5 mg tropisetron were intravenously injected in both groups.In addition, dexmedetomidine 0.6 μg/kg was intravenously infused for 15 min in DS group, while the equal volume of normal saline was given instead in S group.PCIA solution contained sufentanil 2 μg/kg and tropisetron 5 mg in 100 ml of normal saline in S group.PCIA solution contained sufentanil 2 μg/kg, dexmedetomidine 2 μg/kg and tropisetron 5 mg in 100 ml of normal saline in DS group.The PCIA pump was programmed to deliver a 0.5 ml bolus dose with a lockout interval of 15 min and background infusion of 2 ml/h.Observer′s Assessment of Alertness/Sedation Scale scores and scores for patient′s satisfaction with analgesia were recorded at 30 min and 2, 6, 12, 24 and 48 h after surgery.The pressing times of PCIA, total consumption of sufentanil and requirement for morphine as rescue analgesics were recorded.The development of requirement for antiemetics, nausea and vomiting, bradycardia, respiratory depression and agitation was also recorded during analgesia. Results Compared with S group, the pressing times of PCIA, total consumption of sufentanil and requirement for morphine were significantly reduced, scores for satisfaction with analgesia were increased, and Observer′s Assessment of Alertness/Sedation Scale scores were decreased(P 0.05). Conclusion Dexmedetomidine mixed with sufentanil produces better efficacy than sufentanil alone when used for PCIA in the patients undergoing TACE. Key words: Dexmedetomidine; Sufentanil; Hepatic artery; Embolization, therapeutic; Analgesia, patient-controlled