Dexmedetomidine compare with fentanyl for postoperative analgesia in outpatient gynecologic laparoscopy: a randomized controlled trial

Abstract

Background: Low-dose dexmedetomidine provides postoperative analgesia with anti-emetic and anti-shivering. This prospective, randomized, double-blind study was designed to evaluate intraoperative infusion of dexmedetomidine and fentanyl in postoperative analgesia in outpatient gynecologic diagnostic laparoscopy under general anesthesia.

Material and method: Forty ASA physical status I and II patients scheduled for outpatient gynecologic diagnostic laparoscopy were randomly allocated into two groups, dexmedetomidine group (DEX group, n = 20), or fentanyl group (FEN group, n = 20). Either dexmedetomidine 0.5 microg/Kg or fentanyl 0.5 microg/Kg in normal saline 10 ml was infused intravenously for 10 min after induction of general anesthesia. An additional intravenous fentanyl 25 microg was provided for postoperative pain relief in PACU.

Results: Intraoperative hemodynamic data and time to tracheal extubation were similar in both groups. In the PACU, median VRS pain scores were lower in the DEX group at 15 min, 30 min, and 1 h postoperatively (3, 2, and 2 in DEX group vs. 5, 4, and 3 in FEN group, p < 0.05). In addition, the percentage of patients who required treatment of pain was less in the DEX group (45% vs. 85%, p < 0.05). There was less incidence of postoperative nausea in the DEX group (5% vs. 25%, p < 0.05). No statistical difference in shivering and sedation was found between groups.

Conclusion: The present study demonstrates that intravenous infusion of 0.5 microg/Kg of dexmedetomidine after induction of anesthesia was better analgesia than 0.5 microg/Kg of fentanyl in the postoperative period without delayed discharge and provided perioperative hemodynamic stability during gynecologic diagnostic laparoscopy.