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Impact of Dexmedetomidine-Based Opioid-Sparing Anesthesia on Opioid Use After Minimally Invasive Repair of Pectus Excavatum: A Prospective Randomized Controlled Trial

Year: 2024

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Background: Opioid-sparing anesthesia (OSA) using dexmedetomidine has gained attention as an alternative to opioid-based anesthesia (OBA) due to its potential to reduce opioid consumption and the associated side effects. This study aimed to investigate the effect of dexmedetomidine-based OSA on postoperative pain intensity, opioid consumption, and recovery outcomes in patients undergoing a minimally invasive repair of pectus excavatum. Methods: Eighty-four patients undergoing a minimally invasive repair of pectus excavatum were randomized to either the OSA group, receiving dexmedetomidine, or the OBA group, receiving remifentanil. The primary outcome was the total amount of analgesics administered within 24 h postoperatively. The secondary outcomes included pain intensity and analgesic consumption over 48 h, recovery outcomes, intraoperative hemodynamics, and opioid-related complications. Results: The OFA group reported a significantly reduced total morphine-equivalent dose within 24 h (55.4 ± 31.1 mg vs. 80.2 ± 26.7 mg, p < 0.001) and lower VAS scores at 24 h (3.9 ± 1.5 vs. 5.4 ± 2.1, p < 0.001). Pain intensity was lower, and analgesic consumption was reduced in the OSA group 1–6, 6–24, and 24–48 h after surgery. Recovery times and intraoperative hemodynamics were comparable between the groups, with no significant differences in opioid-related complications. Conclusions: Dexmedetomidine-based OSA effectively reduces postoperative pain and opioid use without compromising recovery or hemodynamic stability. These findings support its use as a viable alternative to OBA, particularly in the minimally invasive repair of the pectus excavatum.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm13237264

Authors: Minju Kim, Jaewon Huh, Hoon Choi, Wonjung Hwang

Institutions: The Catholic University of Korea Seoul St. Mary's Hospital, Catholic University of Korea

Language: English

Topic: Anesthesia and Pain Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,955