The experience of using dexmedetomidine as an adjuvant of anesthesia in ophthalmic surgery
Keywords:dexmedetomidine, multimodal anaesthesia, postoperative pain
Various techniques are applied to reduce the severity of postoperative pain and discomfort in patients. The purpose of this research work was to evaluate the effectiveness and safety of Dexmedetomidine as an adjuvant of anesthesia in ophthalmic surgery. The study included 80 patients who underwent corneal transplantation on the basis of Dnepropetrovsk Regional Clinical Ophthalmologic Hospital. Patients were divided into 2 groups: control (group K) – 30 men and main (group D) – 50 ones. Multicomponent balanced anesthesia was applied in both groups. Sibazone was administered as the sedative medicine in the group K, Dexmedetomedin was administered in the group D. The main criteria for evaluating the research results were hallmarked: hemodynamic stability during surgery, the amount of administered opiates, the severity of intraoperative pain syndrome by evaluating the ANI index (ANI – analgesia nociception index), the severity of postoperative pain syndrome and the frequency of postoperative nausea and vomiting (PONV). Both schemes of anesthesia allowed avoiding pronounced fluctuations in hemodynamic parameters and gas exchange at all stages of the study. Analyzing the severity of intraoperative pain, we found that in group K pain relief could be considered insufficient during the first 7 minutes of the most traumatic stage of the surgery, while in group D the ANI index did not fall below 50. Statistically significant differences were obtained on minute 1, 2, 5, 6, and 7 of the surgery. The number of episodes of insufficient anesthesia during the most traumatic stage of the surgery in group K was statistically significantly higher than in group D. Analyzing the quality of pain relief in the postoperative period it was determined, that the level of pain on the Visual Analog Scale (VAS) after awakening in both groups was equal to 0. At the next three stages of the study (2 hours, 6 hours after surgery, and the next morning), the level of pain in group K was significantly higher than in group D. In addition, it was determined that the need for narcotic analgesics and the number of episodes of postoperative nausea and vomiting in group K was statistically significantly higher than in group D. These given data allow us to conclude that Dexmedetomedin is the effective adjuvant of the anesthesia for corneal transplantation.
Antomonov MYu. [Mathematical processing and analysis of biomedical data]. Medinform. 2018;579. Russian.
Volkov PA, Churadze BT, Sevalkin SA, Volkova YuN, Guryanov VA. [Dexmedetomidine as a component of the analgesic component of general anesthesia in laparoscopic operations]. Anesthesiology and Reanimatology. 2015;1:4-8. Russian.
Iklasova FB, Razumov SA, Makalkina LG. [Review of the safety of dexmedetomidine in pediatrics]. Medicine (Almaty). 2018;4(190):165-70. Russian.
Ovechkin AM. [Postoperative Anesthesia in Obstetrics and Gynecology (Analytical Review)]. Regional anesthesia and acute pain management. 2014;8(2):5-16. Russian.
Ovechkin AM. [Postoperative pain relief. Clinical guidelines]. editor AI Saltanov. Intensive Care Bulletin. 2019;4:5-16. Russian. doi: https://doi.org/10.21320/1818-474X-2019-4-9-33
Cherniy VI, Kugler SE. [New opportunities for postoperative pain relief]. Trauma 2. 2016;17(2):29-35. Russian.
Ayvardgi AA, Kobeliatskyy YuYu. [ANI-monitoring in assessing the effectiveness of the anesthetic management for plastic surgery of the nose]. Emergency medicine. 2018;1(88):103-7. Russian. doi: https://doi.org/10.22141/2224-05188.8.131.528.124975
Gregory J, McGowan L. An examination of the prevalence of acute pain for hospitalised adult patients: a systematic review. J Clin Nurs. 2016;25(5-6):583-98. doi: https://doi.org/10.1111/jocn.13094
Roger C, Debra B, Oscar A, Warner L, Steven J. Christopher L. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Com¬mittee, and Administrative Council. The Journal of pain. 2016;17(2):131-57. doi: https://doi.org/10.1016/j.jpain.2015.12.008
Nasreen S, Shahreen S, Huq S. Prevention of Postoperative Adhesions of Caesarean Section. Journal of Bangladesh College of Physicians and Surgeons. 2017;35(2):86-90.
Rawal N. Current issues in postoperative pain management. Eur. J. Anaesthesiol. 2016;33(3):160-71. doi: https://doi.org/10.1097/EJA.0000000000000366
Jae-Hwa Yoo, Soon Im Kim,corresponding author Ana Cho, Sung Jin Lee, Hae Jung Sun, Ho Bum Cho, and Dong Ryun Lee. The effect of dexmedetomidine sedation on patient and surgeon satisfaction during retinal surgery under sub-tenon’s anesthesia: a randomized controlled trial. Korean J. Anesthesiol. 2015;68(5):442-8. doi: https://doi.org/10.4097/kjae.2015.68.5.442
How to Cite
Copyright (c) 2021 Medicni perspektivi (Medical perspectives)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.