Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy.

BACKGROUND: Dexmedetomidine as an adjunct with opioids has been confirmed to spare opioids usage and improve analgesia for postoperative pain treatment. Furthermore, dexmedetomidine can attenuate the airway reflex. The aim of this study is to assess the safety and efficacy of dexmedetomidine combined with sufentanil for postoperative analgesia after partial laryngectomy.

METHODS: A total of 60 adult male patients were recruited and randomly allocated to receive sufentanil 1.0 μg ml-1 (Group S) or sufentanil 1.0 μg ml-1 plus dexmedetomidine 4 μg ml-1 (Group SD) for postoperative analgesia. The IV patient controlled analgesia (PCA) device was programmed to deliver 1.5 ml per demand with a 10 min lockout interval and 1.5 ml per hour background infusion. Cumulative consumption of sufentanil and pain intensity during 24 hour (h) after surgery were recorded. Coughing episodes per day, sleep quality, hemodynamic and respiratory profiles were measured.

RESULTS: Compared with Group S, patients in Group SD required less sufentanil during the 0-24 h postoperative period (p < 0.0001) and reported significant lower pain intensity from the second postoperative hour to the end of the study (P < 0.0001). Daily coughing episodes, sleep disturbance was lower and patients' satisfaction was higher in Group SD (P < 0.05). Decrease in heart rate and mean blood pressure from baseline at 1 h, 2 h, 3 h, 12 h, and 24 h after operation were significantly greater in Group SD (P = 0.00). The incidence of PCA related adverse events were comparable between the two groups.

CONCLUSION: Dexmedetomidine/sufentanil combination for postoperatjve analgesia in partial laryngectomized patients resulted in significant sufentanil sparing, better analgesia, reduced frequency coughing episodes, and better sleep quality.

TRIAL REGISTRATION: Chinese Clinical Registry (ChiCTR): ChiCTR-TRC-14004618 , date of registration: 08 May 2014.