Efficacy of dexmedetomidine in reducing postoperative morphine consumption in patients undergoing total abdominal hysterectomy

Mazlilah Abdul Malek, Nurlia Yahya, Teo Rufinah, Vanitha Sivanaser, Tang Suet Ping Shereen, Raha Abdul Rahman, Norsidah Abdul Manap

Research output: Contribution to journalArticle

Abstract

Introduction: Dexmedetomidine is an alpha-2-adrenergic receptor agonist and neither has respiratory depressant effect nor addictive potential. These favourable properties are useful following major surgical procedures that are associated with significant morbidity caused by pain. This prospective, randomised, double-blinded placebo controlled study was conducted in patients undergoing total abdominal hysterectomy to determine the efficacy of two different doses of intraoperative dexmedetomidine infusions in reducing the amount of morphine consumption during the first 24 hour postoperative period. Materials and Methods: Sixty ASA I or I I patients aged between 35 to 60 years were randomised into three groups to receive intraoperative infusions of dexmedetomidine 0.3 μg/kg/hr (Group A), dexmedetomidine 0.5 μg/kg/hr (Group B) or normal saline as placebo (Group C) without any loading dose, immediately after induction of anaesthesia. Haemodynamic parameters (heart rate and mean arterial pressure) were recorded prior to induction of anaesthesia and at 15 minute intervals intraoperatively. Patients were given patient-controlled analgesia with morphine after surgery and morphine consumption was recorded at 6, 12 and 24 hours postoperatively. Results: Group A and B showed a significant reduction in morphine consumption, compared to Group C and a higher percentage of reduction was noted in Group B as compared to Group A. Group B showed a significant 33% reduction at the 24 hour postoperative period. Mean heart rates were significantly lower in both Group A and B however none of the patients required any rescue drugs. There were no significant differences observed in MAP in all three groups. No side effects were reported. Conclusion: Intraoperative dexmedetomidine infusion of 0.5 μg/kg/hr significantly reduces postoperative morphine consumption when compared to 0.3 μg/kg/hr without causing significant haemodynamic instability and side effects.

Original languageEnglish
Pages (from-to)97-103
Number of pages7
JournalBrunei International Medical Journal
Volume12
Issue number3
Publication statusPublished - 2016

Fingerprint

Dexmedetomidine
Hysterectomy
Morphine
Postoperative Period
Anesthesia
Drug Repositioning
Adrenergic alpha-2 Receptor Agonists
Heart Rate
Hemodynamics
Placebos
Patient-Controlled Analgesia
Arterial Pressure
Morbidity
Pain

Keywords

  • Dexmedetomidine
  • Drug adverse effect
  • Morphine
  • Total abdominal hysterectomy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Efficacy of dexmedetomidine in reducing postoperative morphine consumption in patients undergoing total abdominal hysterectomy. / Malek, Mazlilah Abdul; Yahya, Nurlia; Rufinah, Teo; Sivanaser, Vanitha; Shereen, Tang Suet Ping; Abdul Rahman, Raha; Abdul Manap, Norsidah.

In: Brunei International Medical Journal, Vol. 12, No. 3, 2016, p. 97-103.

Research output: Contribution to journalArticle

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abstract = "Introduction: Dexmedetomidine is an alpha-2-adrenergic receptor agonist and neither has respiratory depressant effect nor addictive potential. These favourable properties are useful following major surgical procedures that are associated with significant morbidity caused by pain. This prospective, randomised, double-blinded placebo controlled study was conducted in patients undergoing total abdominal hysterectomy to determine the efficacy of two different doses of intraoperative dexmedetomidine infusions in reducing the amount of morphine consumption during the first 24 hour postoperative period. Materials and Methods: Sixty ASA I or I I patients aged between 35 to 60 years were randomised into three groups to receive intraoperative infusions of dexmedetomidine 0.3 μg/kg/hr (Group A), dexmedetomidine 0.5 μg/kg/hr (Group B) or normal saline as placebo (Group C) without any loading dose, immediately after induction of anaesthesia. Haemodynamic parameters (heart rate and mean arterial pressure) were recorded prior to induction of anaesthesia and at 15 minute intervals intraoperatively. Patients were given patient-controlled analgesia with morphine after surgery and morphine consumption was recorded at 6, 12 and 24 hours postoperatively. Results: Group A and B showed a significant reduction in morphine consumption, compared to Group C and a higher percentage of reduction was noted in Group B as compared to Group A. Group B showed a significant 33{\%} reduction at the 24 hour postoperative period. Mean heart rates were significantly lower in both Group A and B however none of the patients required any rescue drugs. There were no significant differences observed in MAP in all three groups. No side effects were reported. Conclusion: Intraoperative dexmedetomidine infusion of 0.5 μg/kg/hr significantly reduces postoperative morphine consumption when compared to 0.3 μg/kg/hr without causing significant haemodynamic instability and side effects.",
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AU - Yahya, Nurlia

AU - Rufinah, Teo

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AU - Shereen, Tang Suet Ping

AU - Abdul Rahman, Raha

AU - Abdul Manap, Norsidah

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N2 - Introduction: Dexmedetomidine is an alpha-2-adrenergic receptor agonist and neither has respiratory depressant effect nor addictive potential. These favourable properties are useful following major surgical procedures that are associated with significant morbidity caused by pain. This prospective, randomised, double-blinded placebo controlled study was conducted in patients undergoing total abdominal hysterectomy to determine the efficacy of two different doses of intraoperative dexmedetomidine infusions in reducing the amount of morphine consumption during the first 24 hour postoperative period. Materials and Methods: Sixty ASA I or I I patients aged between 35 to 60 years were randomised into three groups to receive intraoperative infusions of dexmedetomidine 0.3 μg/kg/hr (Group A), dexmedetomidine 0.5 μg/kg/hr (Group B) or normal saline as placebo (Group C) without any loading dose, immediately after induction of anaesthesia. Haemodynamic parameters (heart rate and mean arterial pressure) were recorded prior to induction of anaesthesia and at 15 minute intervals intraoperatively. Patients were given patient-controlled analgesia with morphine after surgery and morphine consumption was recorded at 6, 12 and 24 hours postoperatively. Results: Group A and B showed a significant reduction in morphine consumption, compared to Group C and a higher percentage of reduction was noted in Group B as compared to Group A. Group B showed a significant 33% reduction at the 24 hour postoperative period. Mean heart rates were significantly lower in both Group A and B however none of the patients required any rescue drugs. There were no significant differences observed in MAP in all three groups. No side effects were reported. Conclusion: Intraoperative dexmedetomidine infusion of 0.5 μg/kg/hr significantly reduces postoperative morphine consumption when compared to 0.3 μg/kg/hr without causing significant haemodynamic instability and side effects.

AB - Introduction: Dexmedetomidine is an alpha-2-adrenergic receptor agonist and neither has respiratory depressant effect nor addictive potential. These favourable properties are useful following major surgical procedures that are associated with significant morbidity caused by pain. This prospective, randomised, double-blinded placebo controlled study was conducted in patients undergoing total abdominal hysterectomy to determine the efficacy of two different doses of intraoperative dexmedetomidine infusions in reducing the amount of morphine consumption during the first 24 hour postoperative period. Materials and Methods: Sixty ASA I or I I patients aged between 35 to 60 years were randomised into three groups to receive intraoperative infusions of dexmedetomidine 0.3 μg/kg/hr (Group A), dexmedetomidine 0.5 μg/kg/hr (Group B) or normal saline as placebo (Group C) without any loading dose, immediately after induction of anaesthesia. Haemodynamic parameters (heart rate and mean arterial pressure) were recorded prior to induction of anaesthesia and at 15 minute intervals intraoperatively. Patients were given patient-controlled analgesia with morphine after surgery and morphine consumption was recorded at 6, 12 and 24 hours postoperatively. Results: Group A and B showed a significant reduction in morphine consumption, compared to Group C and a higher percentage of reduction was noted in Group B as compared to Group A. Group B showed a significant 33% reduction at the 24 hour postoperative period. Mean heart rates were significantly lower in both Group A and B however none of the patients required any rescue drugs. There were no significant differences observed in MAP in all three groups. No side effects were reported. Conclusion: Intraoperative dexmedetomidine infusion of 0.5 μg/kg/hr significantly reduces postoperative morphine consumption when compared to 0.3 μg/kg/hr without causing significant haemodynamic instability and side effects.

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KW - Drug adverse effect

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