[Analgesic efficacy of dexmedetomidine as compared to sufentanil in intraperitoneal surgeries: comparative study]

Abstract

Background and objectives: Dexmedetomidine, alpha2-adrenergic agonist with alpha1:alpha2 specificity of 1:1620, does not promote respiratory depression and is intraoperatively used for sedation and analgesia. It has been used associated to opioids in anesthesia for procedures with high painful stimulation, such as intraperitoneal surgeries, and there are no references to its use as single agent. Dexmedetomidine was compared to sufentanil during intraperitoneal procedures in patients above 60 years of age.

Methods: Participated in this study 41 patients randomly distributed in two groups: GS (n = 21), receiving sufentanil, and GD (n = 20) receiving dexmedetomidine for anesthetic induction and maintenance. Patients were given etomidate (GS and GD) with midazolam (GD) for induction and isoflurane and nitrous oxide for maintenance. Hemodynamic attributes (mean blood pressure and heart rate), emergence and extubation times, extubation site (OR or PACU), PACU stay, need for additional analgesia and antiemetics in PACU, OR and PACU complications, Aldrete-Kroulik index at PACU discharge and the need for oxygen mask at PACU discharge were evaluated.

Results: There were no differences in hemodynamic stability. GD group has remained for a shorter time in PACU with lower need for oxygen mask at PACU discharge.

Conclusions: Dexmedetomidine may be used as single analgesic for intraperitoneal procedures in patients above 60 years of age, promoting hemodynamic stability similar to sufentanil, with better recovery profile.