Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study
Abstract Objectives Dexmedetomidine is an alpha-2 agonist with anti-anxiety, sedative, and analgesic effects and causes a lesser degree of respiratory depression. We hypothesized that the use of dexmedetomidine in non-intubated video-assisted thoracic surgery (VATS) may reduce opioid-related complic...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-023-02032-0 |
| _version_ | 1797849888018399232 |
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| author | Hui-Hsuan Ke Jing-Yang Liou Wei-Nung Teng Po-Kuei Hsu Mei-Yung Tsou Wen-Kuei Chang Chien-Kun Ting |
| author_facet | Hui-Hsuan Ke Jing-Yang Liou Wei-Nung Teng Po-Kuei Hsu Mei-Yung Tsou Wen-Kuei Chang Chien-Kun Ting |
| author_sort | Hui-Hsuan Ke |
| collection | DOAJ |
| description | Abstract Objectives Dexmedetomidine is an alpha-2 agonist with anti-anxiety, sedative, and analgesic effects and causes a lesser degree of respiratory depression. We hypothesized that the use of dexmedetomidine in non-intubated video-assisted thoracic surgery (VATS) may reduce opioid-related complications such as postoperative nausea and vomiting (PONV), dyspnea, constipation, dizziness, skin itching, and cause minimal respiratory depression, and stable hemodynamic status. Methods Patients who underwent non-intubated VATS lung wedge resection with propofol combined with dexmedetomidine (group D) or alfentanil (group O) between December 2016 and May 2022 were enrolled in this retrospective propensity score matching cohort study. Intraoperative vital signs, arterial blood gas data, perioperative results and treatment outcomes were analyzed. Of 100 patients included in the study (group D, 50 and group O, 50 patients), group D had a significantly lower degree of decrement in the heart rate and the blood pressure than group O. Intraoperative one-lung arterial blood gas revealed lower pH and significant ETCO2. The common opioid-related side effects, including PONV, dyspnea, constipation, dizziness, and skin itching, all of which occurred more frequently in group O than in group D. Patients in group O had significantly longer postoperative hospital stay and total hospital stay than group D, which might be due to opioid-related side effects postoperatively. Conclusions The application of dexmedetomidine in non-intubated VATS resulted in a significant reduction in perioperative opioid-related complications and maintenance with acceptable hemodynamic performance. These clinical outcomes found in our retrospective study may enhance patient satisfaction and shorten the hospital stay. |
| first_indexed | 2024-04-09T18:51:25Z |
| format | Article |
| id | doaj.art-32151911ab67405db20e9f8acca1da0b |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-09T18:51:25Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-32151911ab67405db20e9f8acca1da0b2023-04-09T11:25:28ZengBMCBMC Anesthesiology1471-22532023-04-0123111110.1186/s12871-023-02032-0Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort studyHui-Hsuan Ke0Jing-Yang Liou1Wei-Nung Teng2Po-Kuei Hsu3Mei-Yung Tsou4Wen-Kuei Chang5Chien-Kun Ting6Department of Anesthesiology, School of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Anesthesiology, School of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Anesthesiology, School of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Anesthesiology, School of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Anesthesiology, School of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Anesthesiology, School of Medicine, National Yang Ming Chiao Tung UniversityDepartment of Anesthesiology, School of Medicine, National Yang Ming Chiao Tung UniversityAbstract Objectives Dexmedetomidine is an alpha-2 agonist with anti-anxiety, sedative, and analgesic effects and causes a lesser degree of respiratory depression. We hypothesized that the use of dexmedetomidine in non-intubated video-assisted thoracic surgery (VATS) may reduce opioid-related complications such as postoperative nausea and vomiting (PONV), dyspnea, constipation, dizziness, skin itching, and cause minimal respiratory depression, and stable hemodynamic status. Methods Patients who underwent non-intubated VATS lung wedge resection with propofol combined with dexmedetomidine (group D) or alfentanil (group O) between December 2016 and May 2022 were enrolled in this retrospective propensity score matching cohort study. Intraoperative vital signs, arterial blood gas data, perioperative results and treatment outcomes were analyzed. Of 100 patients included in the study (group D, 50 and group O, 50 patients), group D had a significantly lower degree of decrement in the heart rate and the blood pressure than group O. Intraoperative one-lung arterial blood gas revealed lower pH and significant ETCO2. The common opioid-related side effects, including PONV, dyspnea, constipation, dizziness, and skin itching, all of which occurred more frequently in group O than in group D. Patients in group O had significantly longer postoperative hospital stay and total hospital stay than group D, which might be due to opioid-related side effects postoperatively. Conclusions The application of dexmedetomidine in non-intubated VATS resulted in a significant reduction in perioperative opioid-related complications and maintenance with acceptable hemodynamic performance. These clinical outcomes found in our retrospective study may enhance patient satisfaction and shorten the hospital stay.https://doi.org/10.1186/s12871-023-02032-0DexmedetomidineNon-intubated video-assisted thoracic surgeryOpioid-related complicationsHemodynamic stabilityHospital stay |
| spellingShingle | Hui-Hsuan Ke Jing-Yang Liou Wei-Nung Teng Po-Kuei Hsu Mei-Yung Tsou Wen-Kuei Chang Chien-Kun Ting Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study BMC Anesthesiology Dexmedetomidine Non-intubated video-assisted thoracic surgery Opioid-related complications Hemodynamic stability Hospital stay |
| title | Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study |
| title_full | Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study |
| title_fullStr | Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study |
| title_full_unstemmed | Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study |
| title_short | Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study |
| title_sort | opioid sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non intubated video assisted thoracoscopic surgery a propensity score matching cohort study |
| topic | Dexmedetomidine Non-intubated video-assisted thoracic surgery Opioid-related complications Hemodynamic stability Hospital stay |
| url | https://doi.org/10.1186/s12871-023-02032-0 |
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