Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysis

Feline FJA ter Bruggen,1 W Ken Redekop,2 Dirk L Stronks,1 Frank JPM Huygen1 1Department of Anesthesiology, Center for Pain Medicine, Erasmus MC, Rotterdam, the Netherlands; 2Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Ro...

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Main Authors: ter Bruggen FFJA, Redekop WK, Stronks DL, Huygen FJPM
Format: Article
Language:English
Published: Dove Medical Press 2021-11-01
Series:Journal of Pain Research
Subjects:
Online Access:https://www.dovepress.com/long-term-effects-of-dexmedetomidine-versus-propofol-during-the-implan-peer-reviewed-fulltext-article-JPR
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author ter Bruggen FFJA
Redekop WK
Stronks DL
Huygen FJPM
author_facet ter Bruggen FFJA
Redekop WK
Stronks DL
Huygen FJPM
author_sort ter Bruggen FFJA
collection DOAJ
description Feline FJA ter Bruggen,1 W Ken Redekop,2 Dirk L Stronks,1 Frank JPM Huygen1 1Department of Anesthesiology, Center for Pain Medicine, Erasmus MC, Rotterdam, the Netherlands; 2Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the NetherlandsCorrespondence: Feline FJA ter Bruggen Tel +31 6 40962334Email ftbruggen@gmail.com; f.terbruggen@erasmusmc.nlObjective: The success of neurostimulation depends partly on the amount of coverage of the neurostimulation-induced paresthesia of the painful area. This is often achieved by asking feedback from patients intraoperatively. If sedation analgesia is used, it is important that the patient is comfortable during sedation and easily arousable. If the patient is not well sedated or experiences residual effects of the sedation during testing, this can directly influence the ideal placement of the leads and indirectly the long-term effect of the treatment. It is our hypothesis that the quality of the sedation is directly coupled to the adequacy of lead placement and in this way in the result of the treatment. Dexmedetomidine is known for its easy production of arousable sedation. The aim of the present study was to compare the long-term effect of using dexmedetomidine versus propofol during the implantation of a neurostimulator.Materials and Methods: This is a post-trial follow-up analysis of the DexMedPro cohort. The primary outcome was global perceived effect (GPE). The secondary outcomes were the course of pain intensity, the emotional and physical functioning at the time of follow-up, and the course of neurostimulation treatment. In this study, we used the patient satisfaction with sedation as a measure for sedation quality.Results: Regarding the GPE, no statistically significant differences were found between the experimental groups in either subscale (ie, recovery (p=0.82) and satisfaction with the neurostimulation treatment at follow-up (p=0.06)). The same was found regarding the secondary parameters. A correlation was found between patient satisfaction with sedation during the lead implantation (side effects and procedural recall) and satisfaction at follow-up.Conclusion: Regarding the long-term efficacy of neurostimulation treatment, no statistically significant differences were found between the dexmedetomidine and the propofol group. We observed a trend towards greater satisfaction with the neurostimulation treatment at follow-up in the dexmedetomidine group, compared to the propofol group.Keywords: dexmedetomidine, propofol, chronic pain, neurostimulation, follow-up, retrospective studies
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spelling doaj.art-442bb6ed26be45fc8a4fe05de154e1472022-12-21T21:23:47ZengDove Medical PressJournal of Pain Research1178-70902021-11-01Volume 143631363671011Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysister Bruggen FFJARedekop WKStronks DLHuygen FJPMFeline FJA ter Bruggen,1 W Ken Redekop,2 Dirk L Stronks,1 Frank JPM Huygen1 1Department of Anesthesiology, Center for Pain Medicine, Erasmus MC, Rotterdam, the Netherlands; 2Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the NetherlandsCorrespondence: Feline FJA ter Bruggen Tel +31 6 40962334Email ftbruggen@gmail.com; f.terbruggen@erasmusmc.nlObjective: The success of neurostimulation depends partly on the amount of coverage of the neurostimulation-induced paresthesia of the painful area. This is often achieved by asking feedback from patients intraoperatively. If sedation analgesia is used, it is important that the patient is comfortable during sedation and easily arousable. If the patient is not well sedated or experiences residual effects of the sedation during testing, this can directly influence the ideal placement of the leads and indirectly the long-term effect of the treatment. It is our hypothesis that the quality of the sedation is directly coupled to the adequacy of lead placement and in this way in the result of the treatment. Dexmedetomidine is known for its easy production of arousable sedation. The aim of the present study was to compare the long-term effect of using dexmedetomidine versus propofol during the implantation of a neurostimulator.Materials and Methods: This is a post-trial follow-up analysis of the DexMedPro cohort. The primary outcome was global perceived effect (GPE). The secondary outcomes were the course of pain intensity, the emotional and physical functioning at the time of follow-up, and the course of neurostimulation treatment. In this study, we used the patient satisfaction with sedation as a measure for sedation quality.Results: Regarding the GPE, no statistically significant differences were found between the experimental groups in either subscale (ie, recovery (p=0.82) and satisfaction with the neurostimulation treatment at follow-up (p=0.06)). The same was found regarding the secondary parameters. A correlation was found between patient satisfaction with sedation during the lead implantation (side effects and procedural recall) and satisfaction at follow-up.Conclusion: Regarding the long-term efficacy of neurostimulation treatment, no statistically significant differences were found between the dexmedetomidine and the propofol group. We observed a trend towards greater satisfaction with the neurostimulation treatment at follow-up in the dexmedetomidine group, compared to the propofol group.Keywords: dexmedetomidine, propofol, chronic pain, neurostimulation, follow-up, retrospective studieshttps://www.dovepress.com/long-term-effects-of-dexmedetomidine-versus-propofol-during-the-implan-peer-reviewed-fulltext-article-JPRdexmedetomidinepropofolchronic painneurostimulationfollow-upretrospective studies
spellingShingle ter Bruggen FFJA
Redekop WK
Stronks DL
Huygen FJPM
Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysis
Journal of Pain Research
dexmedetomidine
propofol
chronic pain
neurostimulation
follow-up
retrospective studies
title Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysis
title_full Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysis
title_fullStr Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysis
title_full_unstemmed Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysis
title_short Long-Term Effects of Dexmedetomidine versus Propofol During the Implantation of a Neurostimulator—A Post-Trial Follow-Up Analysis
title_sort long term effects of dexmedetomidine versus propofol during the implantation of a neurostimulator mdash a post trial follow up analysis
topic dexmedetomidine
propofol
chronic pain
neurostimulation
follow-up
retrospective studies
url https://www.dovepress.com/long-term-effects-of-dexmedetomidine-versus-propofol-during-the-implan-peer-reviewed-fulltext-article-JPR
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