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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2017 Jun 12

DOI: 10.23736/S0375-9393.17.11855-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The impact of Dexmedetomidine or Xylocaine continuous infusion on opioid consumption and quality of recovery following laparoscopic sleeve gastrectomy: a randomized double blinded controlled study

Abeer A. SHERIF, Hazem E. ELSERSY

Department of Anesthesia, Faculty of Medicine, Menofia University, Shebin Alkom, Menofia, Egypt


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BACKGROUND: Postoperative pain control for morbidly obese patients represents a challenge because of their sensitivity towards opioid-induced respiratory depression. We elected both dexmedetomidine and xylocaine (lidocaine) continuous infusions as adjuvants because they lack respiratory depression side effect.
METHODS: 150 ASA I to III patients were enrolled in the study, randomly allocated into three equal parallel groups; the control, lidocaine or dexmedetomidine group. Patients received either dexmedetomidine 1 mcg/kg bolus over 10 minutes followed by 0.4 mcg/kg/h continuous infusion, lidocaine 2 mg/kg bolus over 10 minutes followed by 1.5 mg/kg/h continuous infusion or saline bolus and continuous infusion during the whole operation period. Total morphine consumption was designed to be the primary outcome variable, pain score, and quality of recovery 40 was set as secondary outcome variables. Pain score was measured by numerical rating scale while the quality of recovery score was estimated by the QOR-40 questionnaire. P<0.05 was considered significant.
RESULTS: Both dexmedetomidine and lidocaine reduced the total morphine consumption where it was 14±4, 18±4 and 29±5 mg in Dexmedetomidine, lidocaine and control group respectively P<0.0001. While dexmedetomidine reduced postoperative pain at all measured time points, lidocaine reduced only early pain. Both drugs displayed better quality of recovery score 40 measured at postoperative day 3; 186±2 for dexmedetomidine,176±6 for lidocaine versus 140±6 for the control p<0.0001.
CONCLUSIONS: Continuous infusion of either Dexmedetomidine or xylocaine reduce postoperative opioid consumption, pain and improve the quality of recovery following laparoscopic sleeve gastrectomy.


KEY WORDS: Adjuvant dexmedetomidine - Adjuvant xylocaine - Consumption morphine

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Cite this article as

Sherif AA, Elsersy HE. The impact of Dexmedetomidine or Xylocaine continuous infusion on opioid consumption and quality of recovery following laparoscopic sleeve gastrectomy: a randomized double blinded controlled study. Minerva Anestesiol 2017 Jun 12. DOI: 10.23736/S0375-9393.17.11855-9

Corresponding author e-mail

hazelsersy@hotmail.com