Abstract
BackgroundPostoperative pain is one of the most common symptoms after surgery, which brings physical discomfort to patients. In addition, it may cause a series of complications, and even affect the long-term quality of life. The purpose of this prospective, randomized, double-blinded, controlled trial is to investigate the efficacy and safety of dexmedetomidine combined with sufentanil to attenuate postoperative pain in patients after laparoscopic nephrectomy.MethodsNinety patients undergoing laparoscopic nephrectomy were randomized into three groups: the control (sufentanil 0.02 μg/kg/h, Group C), sufentanil plus low dose of dexmedetomidine (0.02 μg/kg/h each, Group D1), and sufentanil plus high dose of dexmedetomidine (0.04 μg/kg/h, Group D2). The patient-controlled analgesia was programmed to deliver a bolus dose of 0.5 ml, followed by an infusion of 2 ml/h and a lockout time of 10 min. The primary goal was to calculate the cumulative amount of self-administered sufentanil; the secondary goals were to estimate pain intensity using the numerical rating scale (NRS), level of sedation, the first bowel movement, concerning adverse effects as well as duration of postoperative hospital stay.ResultsThe total consumption of sufentanil in group D1 and D2 were significantly lower than in group C during the first 8 h after surgery (P < 0.05), whereas there were no statistically significant differences (P > 0.05) between group D1 and D2. Compared with group C, the NRS scores at rest during first 8 h after surgery were significantly lower in group D1 (P < 0.05). The NRS scores, neither at rest nor with movement, show statistically significant differences between group D1 and D2 at each time point following surgery (P > 0.05). The time to first flatus was shorter in group D1 compared with the control group (P < 0.05). In addition, compared with group C, group D1 and D2 had a shorter time for first defecation (P < 0.05).ConclusionsDexmedetomidine combined with sufentanil showed better postoperative analgesia without adverse effects, as well as facilitated bowel movements for patients undergoing laparoscopic nephrectomy.Trial registrationWe registered this study in a Chinese Clinical Trial Registry (ChiCTR) centre on Dec 23 2015 and received the registration number: ChiCTR-IPR-15007628.
Highlights
Postoperative pain is a common postoperative complication that can aggravate the body’s stress response
Compared with group C, the numerical rating scale (NRS) scores at rest during first 8 h after surgery were significantly lower in group D1 (P < 0.05)
The time to first flatus was shorter in group D1 compared with the control group (P < 0.05)
Summary
Postoperative pain is a common postoperative complication that can aggravate the body’s stress response. It can disturb the endocrine and immune function, as well as it is considered to be a risk factor for postoperative chronic pain. Severe postoperative pain will delay the recovery of patients after surgery, and even influence the quality of long-term survival [1,2,3]. Effective postoperative analgesia has a positive impacts on the recovery of patients following surgery. Postoperative patient-controlled analgesia (PCA) was introduced in the early 1980s. Compared with traditional intramuscular injection of analgesia, PCA can laparoscopic nephrectomy during perioperative period can decrease postoperative sufentanil consumption and pain in-
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