2006, Number 3
Rev Mex Anest 2006; 29 (3)
Dexmedetomidine, bupivacaine and fentanyl vs bupivacaine and fentanyl. Continuous extradural analgesia in lower-extremity surgery
Cedillo-Maguey A, Cárdenas-Jurado J, Juárez-Crescencio O, González-Santillán JM
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ABSTRACTA clinical, comparative trial was carried out to demonstrate whether the extradural infusion of a mixture of dexmedetomidine, bupivacaine and fentanyl had a superior efficacy than the infusion of a mixture of bupivacaine and fentanyl in relieving postoperative pain in patients undergoing orthopedic surgery of the lower limb. One hundred and forty patients, ages 18 to 95, ASA physical status I-III, were randomized into two groups: group 1 (experimental, n = 70), with dexmedetomidine, and group 2 (control, n = 70), without dexmedetomidine. Both groups received the drugs by extradural infusion using a mechanical pumping device. Postoperative analgesia was evaluated using a visual analogue scale; it was considered “satisfactory” when the patients’ score was 0 through 2, and “unsatisfactory” when the score was 3 through 10, in the first 24 hours. There were no statistically significant differences in demographic variables among the two groups. No complications occurred in the perioperative period. Analgesia was considered “unsatisfactory” in one patient (1.5%) in group 1, and in 9 patients (12.8%) in group 2, p ‹ 0.001. We concluded that the dexmedetomidine, plain bupivacaine and fentanyl mixture has a greater efficacy than the plain bupivacaine and fentanyl mixture for the postoperative control of pain in patients undergoing orthopedic surgery of the lower limb.