[Dexmedetomidine and sufentanil as intraoperative analgesics: comparative study]

Abstract

Background and objectives: The use of alpha2-agonists to control heart rate and blood pressure, to attenuate hemodynamic responses to tracheal intubation and extubation and to reduce anesthetics requirement are already well established in the literature since clonidine introduction for therapeutic use. Dexmedetomidine, recently approved for clinical use, presents more alpha2-adrenergic receptors selectively, and therefore less adverse effects combined with marked analgesic and sedative properties. This has raised the interest in using it to replace opioids, known for their potent analgesic and sedative properties. This study aimed at comparing dexmedetomidine and sufentanil analgesias during continuous infusion for ENT, head and neck procedures.

Methods: Sixty patients were randomly distributed in two groups of 30: G1 - sufentanil and G2 - dexmedetomidine, for anesthetic induction and maintenance. Nitrous oxide and propofol in a target controlled continuous infusion were also used for anesthetic maintenance. The following parameters were evaluated: hemodynamic variables (systolic, diastolic blood pressure and heart rate), emergence and extubation times after propofol withdrawal, place where patients were extubated (operating room - OR, or post-anesthetic recovery unit - PACU), PACU stay, Aldrete Kroulik index, and OR or PACU complications.

Results: G1 had lower systolic and diastolic blood pressure, lower heart rate values, longer emergence and extubation times, higher number of PACU extubations, longer PACU stay, lower Aldrete-Kroulik index and higher number of peri and postoperative complications.

Conclusions: Dexmedetomidine as intraoperative analgesic was more effective as compared to sufentanil in the procedures selected for this study regarding hemodynamic stability, emergence and anesthetic recovery conditions.