Clinical effect of dexmedetomidine combined with sufentanil on postoperative analgesia for transthoracic device closure of ventricular septal defects in children with ultrafast track anesthesia

Ultrasound-guided erector spinae plane block for postoperative analgesia in Chinese patients undergoing laparoscopic cholecystectomy: a double-blind randomized controlled trial

PURPOSE

Pain management after laparoscopic cholecystectomy (LC) is a main concern for Chinese clinicians. This study aims to explore the effect of erector spinae plane block (ESPB) on the postoperative analgesia of patients undergoing LC in China.

METHODS

In this randomized controlled trial (RCT), 220 patients were randomized into the ESPB group and control group. Patients in the ESPB group received a bilateral ESPB, and patients in the control group were injected saline. Lornoxicam (0.08 mg/mL, 100 mL) was used as routine analgesia for both groups after the surgery. Visual analog scale (VAS) score at rest state at 12 h postoperative was the primary outcome and divided into no pain, mild pain, moderate pain, and severe pain.

RESULTS

Finally, 197 patients were included for analysis. At postoperative 12 h, ESPB group observed less patients with moderate pain (0% vs. 8.91%) and severe pain (0% vs. 0.99%) than the control group (P < 0.001). Moreover, ESPB group found less dose of additional sufentanil (5.55 ± 1.37 μg vs. 10.67 ± 5.05 μg), less requirement for rescue analgesia (13.54% vs. 31.68%), earlier first time to leave bed (10 h vs. 18 h), and earlier first exhaust time (17.5 h vs. 25 h), less adverse reactions (5.21% vs. 17.82%), and higher satisfaction degree (78.13% vs. 31.68%) (all P < 0.05).

CONCLUSIONS

ESPB was followed by better postoperative analgesia and less opioid consumption.

Analgesic effect of dexmedetomidine in colorectal cancer patients undergoing laparoscopic surgery

OBJECTIVES

To evaluate the analgesic efficacy of intraoperative dexmedetomidine (DEX) for acute postoperative pain in colorectal cancer patients undergoing laparoscopic surgery.

METHODS

We retrospectively analyzed data of 190 colorectal cancer patients who had undergone laparoscopic surgery between October 2020 and May 2021 at Samsung Medical Center, Seoul, Korea, with (n=74) or without intraoperative DEX (n=85) administration. The demographic, clinical, anesthetic, and postoperative data were compared.

RESULTS

In total, 159 patients were enrolled. Demographic and clinical data were not different between the groups. The mean arterial pressure (p<0.001) and heart rate (p<0.001) were lower in the DEX group at the end of surgery and after extubation (p=0.003, p=0.001). The minimum alveolar concentration of sevoflurane was lower in the DEX group during surgery. At the post-anesthesia care unit (PACU) admission and discharge, pain scores (p<0.001, p=0.027) and fentanyl consumption (p<0.001) were significantly lower in the DEX group. On postoperative days 1-3, pain scores and opioid consumption were not different between the groups. The incidence of postoperative complications was not different between the groups.

CONCLUSION

Continuous intraoperative DEX administration had an intraoperative analgesic effect as indicated by lower hemodynamic and fentanyl consumption. Furthermore, there was immediate postoperative analgesia as suspected by the lower pain scores and fentanyl dose during the PACU. However, pain scores and opioid consumption after the PACU remained unaffected.