Comparison of post-operative analgesic efficacy of dexmedetomidine infusion versus infiltration at surgical wound site in microdiscectomies
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 1
Abstract
Background- Patient undergoing spine surgery often suffer from moderate to severe postperative pain and may require large doses of analgesic drugs. Optimizing postoperative pain improves clinical outcomes and increases satisfaction while uncontrolled pain can considerably lead to morbidity and mortality. Aim- In this study we aimed to compare the effectiveness of dexmedetomidine as instillation at surgical site and as intravenous infusion in microdiscectomy. Setting and Design- Randomized, control trial in tertiary care hospital over a period of one year. Material and Method - 90 adult patients, undergoing elective microdiscectomy were randomised into three groups of 30 each. Group A received 100 ml normal saline (NS) infusion in 10 min and wound infiltration with 30 ml ropivacaine 0.2% before wound closure; group B received 100 ml NS infusion over 10 min and wound infiltration of dexmedetomidine 1μg/kg plus 30 ml ropivacaine 0.2% before wound closure; group C received dexmedetomidine 1 μg/kg in 100 ml NS infusion over 10 min and wound infiltration with 30 ml ropivacaine 0.2% before wound closure. The primary observations were visual analogue scores (VAS), postoperative pain scores (PPS) and postoperative fentanyl consumption for 24 hrs. Secondary end points included sedation score, recovery profile and patient satisfaction. Results: Group B showed less pain scores at 4h (p< 0.017), 8 h (p< 0.001), and 24h (p<0.001) when compared to Groups A and C. The requirement of postoperative fentanyl (µg) was 469.84±31.00, 294.17±39.22, 368.33±20.69 for groups A, B and C after 24h (p< 0.001). Group B patients were haemodynamically more stable while group C patients had higher sedation score compared with other groups. Conclusion: Subcutaneous wound instillation with dexmedetomidine and ropivacaine prolonged the pain free period and analgesic consumption, while it also enhanced patient satisfaction.
Authors and Affiliations
Ritika Deshwal, Nidhi Kumar, Jagdish P Sharma, Ranjit Kumar
Keywords
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- EP ID EP589640
- DOI 10.26611/10151018
- Views 161
- Downloads 0
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