Pain fentanyl consumption and delirium in adolescents after scoliosis surgery dexmedetomidine vs midazolam
Yükleniyor...
Dosyalar
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Pediatric Anesthesia
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Background: 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 (12–18 years) requiring mechanical ventilation underwent a continuous
infusion of either dexmedetomidine (group DEX; starting dose,
0.4 lg kg1
h1
) or midazolam (group MDZ; starting dose, 0.1 mg kg1
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 24 h 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 signifi-
cantly 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.
Açıklama
Anahtar Kelimeler
Scoliosis, Sedation, Adolescents, Fentanyl consumption, Pain, Postoperative, Delirium
Kaynak
Pediatric Anesthesia
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
Künye
Aydoğan, M. S. Korkmaz, M. F. Özgül, Ü. Erdoğan, M. A. Yücel, A. Karaman, A. Toğal, T. Durmuş, M. Çolak, C. (2013). Pain fentanyl consumption and delirium in adolescents after scoliosis surgery dexmedetomidine vs midazolam. Pediatric Anesthesia. 23; 446–452.
