Article

2 Iconography
Access to the text (HTML) Access to the text (HTML)
PDF Access to the PDF text
Advertising


Access to the full text of this article requires a subscription.
  • If you are a subscriber, please sign in 'My Account' at the top right of the screen.

  • If you want to subscribe to this journal, see our rates



@@#116300@@

Anaesthesia Critical Care & Pain Medicine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 2 novembre 2018
Doi : 10.1016/j.accpm.2018.08.006
Sedation with dexmedetomidine prolongs the analgesic duration of brachial plexus block: a randomised controlled trial
 

Boohwi Hong a, b, Choonho Jung b, Yumin Jo b, Hyemin Kang b, Woosuk Chung a, b, Yoon-Hee Kim a, b, ChaeSeong Lim a, b, YoungKwon Ko a, b,
a Department of Anaesthesiology and Pain Medicine Chungnam National University College of Medicine, South Korea 
b Department of Anaesthesiology and Pain Medicine Chungnam National University Hospital, South Korea 

Corresponding author: Department of Anaesthesiology and Pain Medicine, Chungnam National University College of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon 35015, South Korea.Department of Anaesthesiology and Pain Medicine, Chungnam National University College of Medicine282, Munhwa-ro, Jung-guDaejeon35015South Korea
Abstract
Purpose

Dexmedetomidine, an alpha 2 receptor agonist, prolongs nerve block duration when administered in conjunction with peripheral nerve blocks. We hypothesised that sedation with dexmedetomidine could also significantly prolong the analgesic duration of brachial plexus block (BPB) during orthopaedic surgery on the upper extremities.

Materials and methods

One hundred and two patients received upper extremity surgery under BPB. The patients were randomly sedated with dexmedetomidine (D group) or midazolam (M group) following BPB using 25 mL of local anaesthetics (1:1 mixture of 1% lidocaine and 0.75% ropivacaine). Adequate sedation was evaluated with the modified Ramsay Sedation Scale. Primary outcome was measured as the time the patient first requested analgesic via a patient-controlled analgesia device. Total opioid consumption during the first 24 post-operative hours was also measured as secondary outcomes.

Results

Time to first request for analgesia (mean ± standard deviation) was significantly longer in the D group (616.9 ± 158.2 min) than in the M group (443.7 ± 127.2 min) (P  < 0.001, Mean difference [95% CI] 173.2 [114.8–231.5] min). Total opioid consumption were significantly lower in the D group (fentanyl equivalent, 280.0 μg [171.3;374.0] vs. 363.9 μg [208.3;570.1], P  = 0.01). Although patients in the D group showed deeper sedation over time (P  < 0.001), PACU stay time was only slightly extended in D group (5.2 [1.2–9.2] min). Perioperative complications did not differ in the two groups.

Conclusion

Sedation with dexmedetomidine not only prolongs analgesic duration of BPB, but also reduces total opioid consumption during the first 24 post-operative hours.

The full text of this article is available in PDF format.

Keywords : Dexmedetomidine, Brachial plexus block, Analgesia, Midazolam




© 2018  Société française d'anesthésie et de réanimation (Sfar)@@#104156@@
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Close
Article Outline