Faculty Collaboration Database

The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery. Anesth Analg 2004 Jan;98(1):153-158

Date

12/25/2003

Pubmed ID

14693611

DOI

10.1213/01.ANE.0000093225.39866.75

Scopus ID

2-s2.0-0347363657 (requires institutional sign-in at Scopus site)   322 Citations

Abstract

UNLABELLED: Thirty-four patients scheduled for elective inpatient surgery were randomized equally to receive either dexmedetomidine (initial loading dose of 1- microg/kg over 10 min followed by 0.4 microg. kg(-1). h(-1) for 4 h) or morphine sulfate (0.08 mg/kg) 30 min before the end of surgery. We determined heart rate (HR), mean arterial blood pressure (MAP), respiratory rate (RR), sedation and analgesia (visual analog scale), and use of additional morphine in the postanesthesia care unit (PACU) and up to 24 h after surgery. Groups were similar for patient demographics, ASA physical status, surgical procedure, baseline hemodynamics, and intraoperative use of drugs and fluids. Dexmedetomidine-treated patients had slower HR in the PACU (by an average of 16 bpm), whereas MAP, RR, and level of sedation were similar between groups. During Phase I recovery, dexmedetomidine-treated patients required significantly less morphine to achieve equivalent analgesia (PACU dexmedetomidine group, 4.5 +/- 6.8 mg; morphine group, 9.2 +/- 5.2 mg). Sixty minutes into recovery only 6 of 17 dexmedetomidine patients required morphine in contrast to 15 of 17 in the morphine group. The administration of dexmedetomidine before the completion of major inpatient surgical procedures significantly reduced, by 66%, the early postoperative need for morphine and was associated with a slower HR in the PACU.

IMPLICATIONS: The use of dexmedetomidine for postoperative analgesia resulted in significantly less additional pain medication (morphine) and slower heart rates than a control group receiving only morphine. These outcomes may prove advantageous for patients who might be placed at higher risk by tachycardia or large doses of morphine.

Author List

Arain SR, Ruehlow RM, Uhrich TD, Ebert TJ

Author

Thomas J. Ebert MD, PhD Adjunct Professor in the Anesthesiology department at Medical College of Wisconsin

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

Analgesics, Non-Narcotic
Analgesics, Opioid
Anesthesia Recovery Period
Blood Pressure
Dexmedetomidine
Double-Blind Method
Female
Heart Rate
Humans
Male
Middle Aged
Morphine
Pain Measurement
Pain, Postoperative
Patient Satisfaction
Respiratory Mechanics