Ultra-rapid opiate detoxification using dexmedetomidine under general anesthesia

Abstract

In this study, ultra-rapid detoxification using dexmedetomidine under general anesthesia (GA) has been evaluated in preventing the withdrawal symptoms in patients addicted to opioids. Sixty male patients who were addicted to opioids were assigned to one of the two groups, in which anesthesia was induced and maintained using propofol infusion: group D = treated with dexmedetomidine during anesthesia and for 6 days after recovery from anesthesia; group C = control group treated after recovery from anesthesia with oral dose of lefoxidine 0.2 mg three times daily. Hemodynamic changes and withdrawal symptoms were assessed using Objective Opiate Withdrawal Scale (OOWS) during anesthesia and both the Objective Opiate Withdrawal Scale (OOWS) and Subjective Opiate Withdrawal Scale (SOWS) after recovery from anesthesia. Patient satisfaction was assessed using 101-point verbal rating scale. Hemodynamic data showed that there were statistically significant increases in heart rate and systolic blood pressure during anesthesia in control group. Control group had significantly higher OOWS score on the following 3 days than the dexmedetomidine group, with no significant changes between the two groups from the fourth day till the sixth day except for muscle twitches in the control group on the sixth day (Cd6). Control group had significantly higher SOWS score on the following 4 days than the dexmedetomidine group, with no significant changes between the two groups on the fifth and sixth days except for yawning, nausea, and muscle twitches in control group on the fifth and sixth days (Cd5, Cd6). Patient satisfaction was significantly greater in dexmedetomidine group than in control group. Dexmedetomidine had shown to decrease markedly the withdrawal symptoms when used during ultra-rapid opiate detoxification under GA, and the patients in this group were more satisfied.