Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam

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dc.authoridDurmus, Mahmut/0000-0001-9594-9064
dc.authoridÇOLAK, CEMİL/0000-0001-5406-098X
dc.authoridYücel, Aytaç/0000-0003-0270-8339
dc.authoridaydogan, mustafa said/0000-0002-7106-1156
dc.authoridOZGUL, Ulku/0000-0003-3738-1751
dc.authoridErdogan, Mehmet Ali/0000-0002-3860-6919
dc.authoridkorkmaz, mehmet/0000-0001-7498-6763
dc.authorwosidDurmus, Mahmut/ABH-3006-2020
dc.authorwosidDurmuş, Mahmut/AAG-3377-2019
dc.authorwosidÇOLAK, CEMİL/ABI-3261-2020
dc.authorwosidYücel, Aytaç/ABI-6137-2020
dc.authorwosidaydogan, mustafa said/AAA-2828-2021
dc.authorwosidErdogan, Mehmet Ali/ABI-7224-2020
dc.authorwosidKARAMAN, Abdurrahman/G-7825-2016
dc.contributor.authorAydogan, Mustafa S.
dc.contributor.authorKorkmaz, Mehmet F.
dc.contributor.authorOzgul, Ulku
dc.contributor.authorErdogan, Mehmet A.
dc.contributor.authorYucel, Aytac
dc.contributor.authorKaraman, Abdurrahman
dc.contributor.authorTogal, Turkan
dc.date.accessioned2024-08-04T20:37:32Z
dc.date.available2024-08-04T20:37:32Z
dc.date.issued2013
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the early postoperative period in adolescents who underwent scoliosis surgery. Methods We performed a prospective, randomized trial in an intensive care unit (ICU) in a tertiary care center. In this study, 42 patients (American Society of Anesthesiology physical status I and II) who underwent scoliosis surgery were divided into two groups according to sedation protocols: group dexmedetomidine (DEX) (n=22) and group midazolam (MDZ) (n=20). Adolescents (1218years) requiring mechanical ventilation underwent a continuous infusion of either dexmedetomidine (group DEX; starting dose, 0.4g center dot kg1 center dot h1) or midazolam (group MDZ; starting dose, 0.1mg center dot kg1 center dot h1) with intermittent fentanyl, as needed. The efficacy of sedation was assessed using the Richmond Agitation Sedation Scale (RASS). Quality of pain relief was measured using the Numeric Visual Analog Scale (NVAS). Delirium was determined in patients in the RASS range of 2 to +1 using the Confusion Assessment Method for the ICU (CAM-ICU). Fentanyl consumption, incidence of delirium, NVAS scores, and hemodynamics were recorded postoperatively at 2, 4, 6, and 24h in the ICU. Results The NVAS pain scores and fentanyl consumption at all the evaluation time points were significantly higher in group MDZ than those in group DEX (P<0.05). Further, total fentanyl consumption in group MDZ was significantly higher than that in group DEX (P<0.05). Delirium was significantly higher in the group MDZ than that in group DEX (31.3% vs 12.5%) when analyzed as the endpoint of CAM-ICU (P<0.05). The heart rate was significantly lower in group DEX compared with that in group MDZ at all the evaluation time points (P<0.05). Conclusion Dexmedetomidine was associated with the decreased postoperative fentanyl consumption, NVAS scores, and a decreased incidence of delirium. These findings may be beneficial for managing sedation protocols in adolescents who have undergone scoliosis surgery.en_US
dc.identifier.doi10.1111/pan.12128
dc.identifier.endpage452en_US
dc.identifier.issn1155-5645
dc.identifier.issue5en_US
dc.identifier.pmid23448434en_US
dc.identifier.scopus2-s2.0-84876490906en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage446en_US
dc.identifier.urihttps://doi.org/10.1111/pan.12128
dc.identifier.urihttps://hdl.handle.net/11616/96017
dc.identifier.volume23en_US
dc.identifier.wosWOS:000317673600012en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWiley-Blackwellen_US
dc.relation.ispartofPediatric Anesthesiaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectscoliosisen_US
dc.subjectsedationen_US
dc.subjectadolescentsen_US
dc.subjectfentanyl consumptionen_US
dc.subjectpainen_US
dc.subjectpostoperativeen_US
dc.subjectdeliriumen_US
dc.titlePain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolamen_US
dc.typeArticleen_US

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