Combination of dexamethasone and dexmedetomidine as adjuvants of transversus abdominis plane block for postoperative analgesia in gastric cancer patients: A double-blinded randomized controlled trial.
J Clin Anesth
; 97: 111543, 2024 Oct.
Article
in En
| MEDLINE
| ID: mdl-38954872
ABSTRACT
STUDY OBJECTIVE:
We conducted this double-blinded randomized controlled trial to examine whether the combination of dexamethasone and dexmedetomidine as adjuvants of transversus abdominis plane (TAP) block could improve analgesia efficacy and duration for gastric cancer patients.DESIGN:
Randomized controlled trial.SETTING:
The preoperative area, operating room, postanesthesia recovery room and bed ward. PATIENTS A total of 312 adult patients (104 per group) with gastric cancer were included.INTERVENTIONS:
Patients received bilateral subcostal TAP block with three different anesthetics (60 ml 0.25% ropivacaine added with 10 mg dexamethasone and 1 µg·kg-1 dexmedetomidine [A] or 10 mg dexamethasone [B] or 1 µg·kg-1 dexmedetomidine [C]). MEASUREMENTS The primary outcome was the incidence of moderate-to-severe pain 24 h on movement. Secondary outcomes included incidence of moderate-to-severe pain, pain score, opioids use, recovery quality and adverse events. MAINRESULTS:
The incidence of moderate-to-severe pain on movement 24 h postoperatively of group A was significantly lower than group B (45.19% vs 63.46%; RR 0.71; 95% CI, 0.55 to 0.92) and group C (45.19% vs 73.08%, RR 0.62; 95% CI, 0.49 to 0.79). The median moving pain scores decreased significantly at 24 h (3.00 [3.00,5.00] vs 4.00 [3.00,6.00] vs 4.00 [3.00,5.00]; P < 0.001). There were significant differences in the opioids consumption within the first 24 h (27.5 [17.0,37.2] vs 30.0 [20.0,42.0] vs 32.0 [25.0,44.0] mg; P = 0.01) and the duration to first rescue analgesia (65.5 ± 26.7 vs 45.9 ± 34.5 vs 49.2 ± 27.2 h; P = 0.04).CONCLUSIONS:
The combination with dexamethasone and dexmedetomidine as adjuvants for TAP block reduced the incidence of moderate-to-severe pain and pain score both on movement and at rest at 24 h with prolonged duration to first rescue analgesia after gastric cancer surgery. TRIAL REGISTRATION NUMBER ChiCTR2000037981.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pain, Postoperative
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Stomach Neoplasms
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Pain Measurement
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Dexamethasone
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Abdominal Muscles
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Dexmedetomidine
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Anesthetics, Local
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Nerve Block
Limits:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
J Clin Anesth
/
J. clin. anesth
/
Journal of clinical anesthesia
Journal subject:
ANESTESIOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
China
Country of publication:
Estados Unidos