Analgesic Effects of Dexmedetomidine and Remifentanil in Patients with Herniated Disc

Authors

  • Mohsen Dalvandi Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran Author
  • Taher Amini Maleki Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran Author
  • Alireza Kamali Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran Author
  • Ali Nazemi Rafie Department of Neurosurgery, Arak University of Medical Sciences, Arak, Iran Author

DOI:

https://doi.org/10.61841/h7qzvk47

Keywords:

Apotel, Dexmedetomidine, Remifentanil, Pain Reduction, Herniated Disc

Abstract

Introduction: The purpose of this study was to compare analgesic effects of dexmedetomidine with those of remifentanil in patients undergoing herniated disc surgery.

Material and Methods: In this double-blind clinical trial study, 96 patients who were candidates for herniated disc surgery were enrolled. Patients were randomly divided into three groups with epidural block. In all three groups, leg and back pain were recorded within 2, 6, 12, and 24 hours after surgery. Patient sedation was recorded by Ramsay sedation score within 2, 6, 12, and 24 hours postoperatively. Data were analyzed by SPSS 20 software.

Results: Foot pain and low back pain were lower in the dexmedetomidine-apotel group within 2 to 24 hours after surgery (p < 0.05). There was a statistically significant difference between the three groups in terms of sedation within 2 to 24 hours after surgery (p < 0.05). Furthermore, sedation was found to be higher in the apotel/normal saline group than the other two groups 2 to 6 hours after surgery. But no significant difference was observed between the dexmedetomidine-apotel and remifentanil-apotel groups (p < 0.05).

Conclusion: Dexmedetomidine-apotel was capable of reducing back and leg pain in the postoperative period, but there is no difference between dexmedetomidine-apotel and remifentanil-apotel in sedation. 

Downloads

Download data is not yet available.

References

[1] Churojana O CA, Chiewvit P, Charnchaowowanish P. The limited protocol MRI in the diagnosis of lumbar disc herniation. Introduction. J Med Assoc Thai. 2006;89(2):182-9.

[2] Terry Canale S JB. Operative orthopaedics. 11, editor. China: Mosby, 2008.

[3] Sinatra Rs. Acute pain management. 1, editor: Cambridge University Press; 2009.

[4] RD M. Anesthesia. Churchill Livingston, 2015.

[5] BB R. Are postoperative narcotics necessary? Arch Surg. 1963;87:912–5.

[6] PH S. Objective measurement of pain. Anesthesiology. 1968;29:209–10.

[7] PH S. Studies in pain with the analgesic-demand system. Anesth Analg. 1971;50:1-10.

[8] Svensson C YT. Theprostanoid cascade in nociceptive processing.

Annu Rev Pharmacol Toxicol 2002;42:553–83.

[9] Wilgus T RM, Parrett M, Oberyszyn T. Topical application of a selective cyclooxygenase inhibitor

suppresses UVB-mediated cutaneous inflammation. Prostaglandins Other Lipid Mediat 2000;62:367–84.

[10] Kamali A, Hojati Ashrafi T, Rakei S, Noori G, Norouzi A. A comparative study on the prophylactic effects of paracetamol and dexmedetomidine for controlling hemodynamics during surgery and postoperative pain in patients with laparoscopic cholecystectomy. Medicine (Baltimore). 2018; 97(51): e13330.

[11] Crawford D FD, Achola K, Smith G. Effect of alfentanil on the pressor and catecholamine responses to tracheal intubation. Br J Anaesth. 1987;59(6):707-12.

[12] Janatmakan F, Nesion pour S, Vaziri M. Comparison of premedication with dexmedetomidine and clonidine. Ahvaz: Ahvaz Medical Sciences University, 2016.

[13] Hagiwara C MK, Fukukita K. Use of remifentanil in a patient with renal failure and liver dysfunction

undergoing hepatectomy. Anesthesiology. 2001;94:211-7.

[14] Anthony L KL. Comparison of remifentanil versus fentanyl general anesthesia for short outpatient urologic

procedures. Signa Vitae 2009;4:23-9.

[15] Miller D. Basics of anesthesia. Tehran: Artin Teb, 2018.

[16] R. M. Miller's Anesthesia, 8th ed. Philadelphia: Churchill Livingstone/Elsevier; 2015.

[17] Anderson J GU, Siegel H, Dahl J, Aex M, Mathiesen O, et al. Does Dexmedetomidine Have a

Perineural Mechanism of Action When Used as an Adjuvant to Ropivacaine?: A Paired, Blinded,

Randomized Trial in Healthy Volunteers. Anesthesiology. 2017;126:66-73.

[18] Kamali A , Vakilian K , Mortazavi L , M S. The Effects of Apotel and Remifentanil on Postoperative Pain.

Alternative Therapies in Health and Medicine. 2018.

[19] Ke Peng, Liu H-y, and Si-lan Liu. Dexmedetomidine-fentanyl Compared With Midazolam-fentanyl for Conscious Sedation in Patients Undergoing Lumbar Disc Surgery. Clinical Therapeutics. 2016;38(1):192-201.

[20] Balki M, Kasodekar S, MBBS SD, Bernstein P, Carvalho JCA. Remifentanil patient-controlled analgesia for labor: optimizing drug delivery regimens. Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 2007;54(8):626-33.

[21] Alhashemi JA, Kaki AM. Dexmedetomidine in combination with morphine PCA provides superior analgesia for shockwave lithotripsy. Canadian Journal of Anesthesia/Journal canadien 2004;51:342.

Downloads

Published

31.07.2020

How to Cite

Dalvandi, M., Amini Maleki, T., Kamali, A., & Nazemi Rafie, A. (2020). Analgesic Effects of Dexmedetomidine and Remifentanil in Patients with Herniated Disc. International Journal of Psychosocial Rehabilitation, 24(5), 7461-7468. https://doi.org/10.61841/h7qzvk47