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

dc.authorid9217en_US
dc.contributor.authorAydoğan, Mustafa Said
dc.contributor.authorKorkmaz, Mehmet Fatih
dc.contributor.authorÖzgül, Ülkü
dc.contributor.authorErdoğan, Mehmet Ali
dc.contributor.authorYücel, Aytaç
dc.contributor.authorKaraman, Abdurrahman
dc.contributor.authorToğal, Türkan
dc.contributor.authorDurmuş, Mahmut
dc.contributor.authorÇolak, Cemil
dc.date.accessioned2017-08-18T11:44:33Z
dc.date.available2017-08-18T11:44:33Z
dc.date.issued2013
dc.departmentFakülteler, Sanat ve Tasarım Fakültesi, Grafik Bölümüen_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 (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.en_US
dc.identifier.citationAydoğan, 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.en_US
dc.identifier.doi10.1111/pan.12128.en_US
dc.identifier.endpage452en_US
dc.identifier.startpage446en_US
dc.identifier.urihttps://hdl.handle.net/11616/7629
dc.identifier.volume23en_US
dc.language.isoenen_US
dc.publisherPediatric Anesthesiaen_US
dc.relation.ispartofPediatric Anesthesiaen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_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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