Influence of dexmedetomidine and lidocaine on perioperative opioid consumption in laparoscopic intestine resection: a randomized controlled clinical trial

Lea Andjelković, Vesna Novak-Jankovič, Neva Požar-Lukanovič, Zoran Bosnić, Alenka Spindler-Vesel, Lea Andjelković, Vesna Novak-Jankovič, Neva Požar-Lukanovič, Zoran Bosnić, Alenka Spindler-Vesel

Abstract

Objective: The consumption of opioid analgesics could be reduced by the use of analgesics with different mechanisms of action. We investigated whether additional treatment with dexmedetomidine or lidocaine could reduce opioid consumption.

Methods: We randomized 59 study participants into three groups and examined: (i) fentanyl consumption, (ii) consumption of piritramide, and (iii) cognitive function and neuropathic pain. The control group received continuous propofol infusion and fentanyl boluses. Continuous intravenous infusion of dexmedetomidine (0.5 µg/kg/h) was administered to the dexmedetomidine group and lidocaine (1.5 mg/kg/h) was administered to the lidocaine group.

Results: No reduction in fentanyl consumption was observed among the groups. However, we noted a significantly lower consumption of piritramide on the first and second postoperative day in the lidocaine group. Total consumption of piritramide was significantly lower in the lidocaine group compared with the control group.

Conclusions: Lidocaine and dexmedetomidine reduced intraoperative propofol consumption, while lidocaine reduced postoperative piritramide consumption. Clinical trial registration: NCT02616523.

Keywords: Analgesia; cognitive function; dexmedetomidine; laparoscopy; lidocaine; neuralgia.

Figures

Figure 1.
Figure 1.
Flow diagram of the study.
Figure 2.
Figure 2.
Fentanyl consumption per patient group.
Figure 3.
Figure 3.
Piritramide consumption per body weight among the patient groups.
Figure 4.
Figure 4.
Propofol consumption per patient group.
Figure 5.
Figure 5.
Average VAS score per patient group. VAS = visual analogue scale

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Source: PubMed

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