Efficacy of dexmedetomidine-based opioid-free anesthesia on the control of surgery-induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomy
Objectives To compare the effect of opioid-based (OB-GA) versus opioid-free intraoperative analgesia during general anesthesia (OF-GA) and epidural anesthesia (EA) during open abdominal hysterectomy on pro-inflammatory cytokines’ levels estimated in blood samples obtained at end of surgery (S2) and...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2118412 |
| _version_ | 1811183172568743936 |
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| author | Mohamed A Lotfy Mohamed G Ayaad |
| author_facet | Mohamed A Lotfy Mohamed G Ayaad |
| author_sort | Mohamed A Lotfy |
| collection | DOAJ |
| description | Objectives To compare the effect of opioid-based (OB-GA) versus opioid-free intraoperative analgesia during general anesthesia (OF-GA) and epidural anesthesia (EA) during open abdominal hysterectomy on pro-inflammatory cytokines’ levels estimated in blood samples obtained at end of surgery (S2) and 24-hr (S3) postoperative (PO).Patients Patients of OF-GA group received loading doses of dexmedetomidine (DEX; 0.6 µg/kg) and Lidocaine (LID; 1.5 mg/kg) and intraoperative (IO) DEX (1 µg/kg) and LID (20 mg/ ml) infusions. GA was provided as sevoflurane inhalational anesthesia and EA was provided as loading dose (15 ml) of 0.5% bupivacaine and intermittent doses if required. The study outcome is the effect of anesthetic techniques on S2 and S3-samples’ serum cytokines’ levels.Results PO serum cytokines’ levels were significantly higher than preoperative levels with significantly higher levels in S2-sample of patients OB-GA patients compared to patients of other groups. In the S3 sample, serum cytokines’ levels were decreased after OB-GA but increased after OF-GA and EA. OF-GA provided better IO hemodynamic control and PO lower cytokines’ levels, pain scores and consumption of rescue analgesia. Satisfaction scores were significantly higher by OF-GA and LA.Conclusion DEX-based OF-GA provided better IO and PO control on surgical inflammatory response with improved PO outcomes regarding analgesia and adverse effects. EA also allowed IO control on cytokines’ levels but PO rebound was detected. |
| first_indexed | 2024-04-11T09:43:22Z |
| format | Article |
| id | doaj.art-a2f9ded4b5c942e59166ad0eb8185467 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-11T09:43:22Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-a2f9ded4b5c942e59166ad0eb81854672022-12-22T04:31:08ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492022-12-0138149750410.1080/11101849.2022.2118412Efficacy of dexmedetomidine-based opioid-free anesthesia on the control of surgery-induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomyMohamed A Lotfy0Mohamed G Ayaad1Department of Anesthesia & Intensive Care, Faculty of Medicine, Tanta University, Tanta, EgyptDepartment of Anesthesia & Intensive Care, Faculty of Medicine, Tanta University, Tanta, EgyptObjectives To compare the effect of opioid-based (OB-GA) versus opioid-free intraoperative analgesia during general anesthesia (OF-GA) and epidural anesthesia (EA) during open abdominal hysterectomy on pro-inflammatory cytokines’ levels estimated in blood samples obtained at end of surgery (S2) and 24-hr (S3) postoperative (PO).Patients Patients of OF-GA group received loading doses of dexmedetomidine (DEX; 0.6 µg/kg) and Lidocaine (LID; 1.5 mg/kg) and intraoperative (IO) DEX (1 µg/kg) and LID (20 mg/ ml) infusions. GA was provided as sevoflurane inhalational anesthesia and EA was provided as loading dose (15 ml) of 0.5% bupivacaine and intermittent doses if required. The study outcome is the effect of anesthetic techniques on S2 and S3-samples’ serum cytokines’ levels.Results PO serum cytokines’ levels were significantly higher than preoperative levels with significantly higher levels in S2-sample of patients OB-GA patients compared to patients of other groups. In the S3 sample, serum cytokines’ levels were decreased after OB-GA but increased after OF-GA and EA. OF-GA provided better IO hemodynamic control and PO lower cytokines’ levels, pain scores and consumption of rescue analgesia. Satisfaction scores were significantly higher by OF-GA and LA.Conclusion DEX-based OF-GA provided better IO and PO control on surgical inflammatory response with improved PO outcomes regarding analgesia and adverse effects. EA also allowed IO control on cytokines’ levels but PO rebound was detected.https://www.tandfonline.com/doi/10.1080/11101849.2022.2118412Opioid-freeepidural anesthesiageneral anesthesiahysterectomyinflammatory cytokines |
| spellingShingle | Mohamed A Lotfy Mohamed G Ayaad Efficacy of dexmedetomidine-based opioid-free anesthesia on the control of surgery-induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomy Egyptian Journal of Anaesthesia Opioid-free epidural anesthesia general anesthesia hysterectomy inflammatory cytokines |
| title | Efficacy of dexmedetomidine-based opioid-free anesthesia on the control of surgery-induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomy |
| title_full | Efficacy of dexmedetomidine-based opioid-free anesthesia on the control of surgery-induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomy |
| title_fullStr | Efficacy of dexmedetomidine-based opioid-free anesthesia on the control of surgery-induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomy |
| title_full_unstemmed | Efficacy of dexmedetomidine-based opioid-free anesthesia on the control of surgery-induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomy |
| title_short | Efficacy of dexmedetomidine-based opioid-free anesthesia on the control of surgery-induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomy |
| title_sort | efficacy of dexmedetomidine based opioid free anesthesia on the control of surgery induced inflammatory response and outcomes in patients undergoing open abdominal hysterectomy |
| topic | Opioid-free epidural anesthesia general anesthesia hysterectomy inflammatory cytokines |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2118412 |
| work_keys_str_mv | AT mohamedalotfy efficacyofdexmedetomidinebasedopioidfreeanesthesiaonthecontrolofsurgeryinducedinflammatoryresponseandoutcomesinpatientsundergoingopenabdominalhysterectomy AT mohamedgayaad efficacyofdexmedetomidinebasedopioidfreeanesthesiaonthecontrolofsurgeryinducedinflammatoryresponseandoutcomesinpatientsundergoingopenabdominalhysterectomy |