Faculty Collaboration Database

The impact of perioperative dexmedetomidine infusion on postoperative narcotic use and duration of stay after laparoscopic bariatric surgery. J Gastrointest Surg 2007 Nov;11(11):1556-9

Date

08/22/2007

Pubmed ID

17710502

DOI

10.1007/s11605-007-0290-0

Scopus ID

2-s2.0-35148829142 (requires institutional sign-in at Scopus site)   47 Citations

Abstract

Dexmedetomidine (Precedex, Hospira, Lake Forest, IL) is an alpha-2 receptor agonist with sedative and analgesic sparing properties. This medication has not been associated with respiratory suppression, despite occasionally high levels of sedation. For 10 months, all patients undergoing a laparoscopic bariatric procedure received a dexmedetomidine infusion 30 min before the anticipated completion of the procedure (n = 34). A control group was comprised of a similar number of patients to have had laparoscopic bariatric surgery in the time period immediately before these 10 months (n = 37). All pathways and discharge criteria were identical for patients in each group. A total of 73 patients were included in this retrospective chart review. Two gastric bypass patients were excluded for complications requiring additional surgery (one bleed and one leak). Gastric bypass patients who received a dexmedetomidine infusion required fewer narcotics (66 vs 130 mg of morphine equivalents) than control patients and met discharge criteria on post-op day (POD) 1 more often (61% discharged POD 1 vs 26% discharged POD 1, p = 0.02). Vital signs and pain scores were similar in all groups. Dexmedetomidine infusion perioperatively is safe and may help to minimize narcotic requirements and decrease duration of stay after laparoscopic bariatric procedures. This may have important patient safety ramifications in a patient population with a high prevalence of obstructive sleep apnea. A well-organized prospective, randomized, double-blinded trial is necessary to confirm the benefits of dexmedetomidine suggested by this study.

Author List

Dholakia C, Beverstein G, Garren M, Nemergut C, Boncyk J, Gould JC

Author

Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Dexmedetomidine
Female
Gastric Bypass
Gastroplasty
Humans
Hypnotics and Sedatives
Length of Stay
Male
Narcotics
Perioperative Care
Postoperative Period
Retrospective Studies