Dexmedetomidine Compare with Fentanyl for Postoperative Analgesia in Outpatient Gynecologic Laparoscopy: A Randomized Controlled Trial
Anchalee Techanivate MD*, Sasima Dusitkasem MD*, Chanida Anuwattanavit MD*
Affiliation : * Department of Anesthesiology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Background : Low-dose dexmedetomidine provides postoperative analgesia with anti-emetic and anti-shivering. This
prospective, randomized, double-blind study was designed to evaluate intraoperative infusion of dexmedetomidine and
fentanyl in postoperative analgesia in outpatient gynecologic diagnostic laparoscopy under general anesthesia.
Material and Method: Forty ASA physical status I and II patients scheduled for outpatient gynecologic diagnostic laparoscopy
were randomly allocated into two groups, dexmedetomidine group (DEX group, n = 20), or fentanyl group (FEN group,
n = 20). Either dexmedetomidine 0.5 μg/Kg or fentanyl 0.5 μg/Kg in normal saline 10 ml was infused intravenously for
10 min after induction of general anesthesia. An additional intravenous fentanyl 25 μg was provided for postoperative pain
relief in PACU.
Results : Intraoperative hemodynamic data and time to tracheal extubation were similar in both groups. In the PACU, median
VRS pain scores were lower in the DEX group at 15 min, 30 min, and 1 h postoperatively (3, 2, and 2 in DEX group vs. 5, 4,
and 3 in FEN group, p < 0.05). In addition, the percentage of patients who required treatment of pain was less in the DEX
group (45% vs. 85%, p < 0.05). There was less incidence of postoperative nausea in the DEX group (5% vs. 25%, p < 0.05).
No statistical difference in shivering and sedation was found between groups.
Conclusion : The present study demonstrates that intravenous infusion of 0.5 μg/Kg of dexmedetomidine after induction of
anesthesia was better analgesia than 0.5 μg/Kg of fentanyl in the postoperative period without delayed discharge and
provided perioperative hemodynamic stability during gynecologic diagnostic laparoscopy.
Keywords : Dexmedetomidine, Analgesia, Laparoscopy
