[Dexmedetomidine and sufentanil as intraoperative analgesics: comparative study.].
OBJECTIVE
The use of alpha2-agonists to control heart rate and blood pressure, to attenuate hemodynamic responses to tracheal intubation and extubation and to reduce anesthetics requirement are already well established in the literature since clonidine introduction for therapeutic use. Dexmedetomidine, recently approved for clinical use, presents more alpha2-adrenergic receptors selectively, and therefore less adverse effects combined with marked analgesic and sedative properties. This has raised the interest in using it to replace opioids, known for their potent analgesic and sedative properties. This study aimed at comparing dexmedetomidine and sufentanil analgesias during continuous infusion for ENT, head and neck procedures.


METHODS
Sixty patients were randomly distributed in two groups of 30: G1 - sufentanil and G2 - dexmedetomidine, for anesthetic induction and maintenance. Nitrous oxide and propofol in a target controlled continuous infusion were also used for anesthetic maintenance. The following parameters were evaluated: hemodynamic variables (systolic, diastolic blood pressure and heart rate), emergence and extubation times after propofol withdrawal, place where patients were extubated (operating room - OR, or post-anesthetic recovery unit - PACU), PACU stay, Aldrete Kroulik index, and OR or PACU complications.


RESULTS
G1 had lower systolic and diastolic blood pressure, lower heart rate values, longer emergence and extubation times, higher number of PACU extubations, longer PACU stay, lower Aldrete-Kroulik index and higher number of peri and postoperative complications.


CONCLUSIONS
Dexmedetomidine as intraoperative analgesic was more effective as compared to sufentanil in the procedures selected for this study regarding hemodynamic stability, emergence and anesthetic recovery conditions.
Curtis
Fábio Geraldo
FG
Departamento de Anestesiologia, FMB, UNESP.
Castiglia
Yara Marcondes Machado
YM
Stolf
Andrea Albres
AA
Ronzella
Erick
E
Vanni
Simone Maria D Angelo
SM
Nascimento Junior
Paulo do
Pd