Sami Abu-Halaweh1, Firas Obeidat2, Anthony R Absalom3, Abdelkareem AlOweidi1, Mahmood Abu Abeeleh2, Ibrahim Qudaisat1, Fay Robinson4, Keira P Mason5. 1. Department of Anesthesia and ICU, Faculty of Medicine, University of Jordan and Jordan University Hospital, Amman, Jordan. 2. Department of Surgery, Faculty of Medicine, University of Jordan and Jordan University Hospital, Amman, Jordan. 3. Department of Anesthesia, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. 4. Statistical Programmer, DM-Stat, Inc., Malden, MA, USA. 5. Department of Anesthesia, Perioperative and Pain Medicine, Harvard Medical School, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA, 02115, USA. keira.mason@childrens.harvard.edu.
Abstract
INTRODUCTION: The primary aim of this pilot study was to determine whether the dexmedetomidine infusion initiated immediately after laparoscopic bariatric surgery, offers an advantage over a morphine infusion with respect to rescue morphine and paracetamol requirements over the first 24 post-operative hours. METHODS:Sixty morbidly obese adult patients scheduled for laparoscopic bariatric surgery were randomly assigned to receive an infusion of either 0.3 mcg/kg/h dexmedetomidine (Group D) or 3 mg/h Morphine (Group M) for 24 h immediately post-operatively. All patients received standardized general anesthesia and were evaluated and treated for pain in the intensive care unit by providers who were blinded to their treatment group. The primary outcome was the need for supplemental, "rescue" paracetamol (Dolargan. Hikma, Jordan) and morphine titrated to achieve visual analog scales (VAS) of <40 and <70, respectively. RESULTS: A total of 60 patients (77 % female, mean age 33.5 years ± 9.5 and body mass index (BMI) 43.0 ± 4.5) were randomized to Group M and 30 to Group D. There were no significant differences in mean rescue paracetamol and morphine requirements. Mean total morphine requirements in Group D were 6.1 ± 3.1 mg, whereas 72.9 ± 2.2 mg in Group M (p < 0.0001). CONCLUSIONS: An intravenous infusion of dexmedetomidine, initiated and continued for 24 h following laparoscopic bariatric surgery, can decrease the overall morphine requirements during this period. This pilot study demonstrated that the post-operative initiation of dexmedetomidine can be morphine sparing following laparoscopic bariatric surgery.
RCT Entities:
INTRODUCTION: The primary aim of this pilot study was to determine whether the dexmedetomidine infusion initiated immediately after laparoscopic bariatric surgery, offers an advantage over a morphine infusion with respect to rescue morphine and paracetamol requirements over the first 24 post-operative hours. METHODS: Sixty morbidly obese adult patients scheduled for laparoscopic bariatric surgery were randomly assigned to receive an infusion of either 0.3 mcg/kg/h dexmedetomidine (Group D) or 3 mg/h Morphine (Group M) for 24 h immediately post-operatively. All patients received standardized general anesthesia and were evaluated and treated for pain in the intensive care unit by providers who were blinded to their treatment group. The primary outcome was the need for supplemental, "rescue" paracetamol (Dolargan. Hikma, Jordan) and morphine titrated to achieve visual analog scales (VAS) of <40 and <70, respectively. RESULTS: A total of 60 patients (77 % female, mean age 33.5 years ± 9.5 and body mass index (BMI) 43.0 ± 4.5) were randomized to Group M and 30 to Group D. There were no significant differences in mean rescue paracetamol and morphine requirements. Mean total morphine requirements in Group D were 6.1 ± 3.1 mg, whereas 72.9 ± 2.2 mg in Group M (p < 0.0001). CONCLUSIONS: An intravenous infusion of dexmedetomidine, initiated and continued for 24 h following laparoscopic bariatric surgery, can decrease the overall morphine requirements during this period. This pilot study demonstrated that the post-operative initiation of dexmedetomidine can be morphine sparing following laparoscopic bariatric surgery.
Entities:
Keywords:
Adverse events; Quality and outcomes; Sedation
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