Impact of Intraoperative Dexmedetomidine versus Remifentanil on Recovery Characteristics following Laparoscopic Sleeve Gastrectomy.

Abstract

To evaluate the impact of intraoperative dexmedetomidine versus remifentanil on postoperative pain; and enhanced recovery profile in patients scheduled for laparoscopic sleeve gastrectomy (LSG). Clinical observational double-blind pilot study. King Khalid University Hospital, affiliated with King Saud University, Riyadh, Saudi Arabia, from December 2019 to March 2020. Forty adult patients with body mass index (BMI) >35 Kg/m2were divided into two equal groups: group dexmedetomidine (D) and group remifentanil (R). In the post-anaesthesia care unit (PACU) and for 24 hours in the ward, the patients were assessed for pain score and other recovery characteristics. In the PACU, the mean values of numerical rating scale (NRS) were 4.26±1.97 vs. 4.15±1.9 and morphine consumption median values were 4 vs. 1 mg in groups D and R, respectively (p >0.05). The number of patients who developed shivering were 0 vs. 6 in groups D and R, respectively (p <0.05). Sedation agitation scale (SAS) median values were 4 vs. 4 (p <0.05), postoperative nausea and vomiting (PONV) frequency was 1 vs. 6 (p >0.05) in groups D and R, respectively. The length of hospital stay (LOS) median values were 1 vs. 1 day in groups D and R, respectively (p >0.05). Better enhanced recovery profile after LSG supports the use of intraoperative infusion of dexmedetomidine as an anaesthetic adjuvant versus remifentanil. Key Words: Dexmedetomidine, Remifentanil, Enhanced recovery after surgery (ERAS); Bariatric surgery.