title: Comparison of the efficacy of dexmedetomidine plus fentanyl patient-controlled analgesia with fentanyl patient-controlled analgesia for pain control in uterine artery embolization for symptomatic fibroid tumors or adenomyosis: a prospective, randomized study.
abstract: OBJECTIVE
  To investigate whether dexmedetomidine infusion could reduce opioid consumption and opioid-related side effects after uterine artery embolization (UAE).
  
  
  METHODS
  Fifty patients undergoing UAE for symptomatic leiomyomas or adenomyosis were randomized into two groups. In 25 patients, dexmedetomidine infusion was started at 0.2 μg/kg/h at 30 minutes before the procedure, followed by 0.4 μg/kg/h for 6 hours after the procedure. In another 25 patients (control group), volume-matched normal saline solution was administered. Both groups received fentanyl-based intravenous patient-controlled analgesia (PCA; fentanyl 10 μg/h with a bolus dose of 20 μg) during the 24 hours after the procedure. Nonspherical polyvinyl alcohol particles were used. Pain scores, fentanyl consumption, need for additional analgesics, and side effects were assessed for 24 hours after UAE.
  
  
  RESULTS
  Compared with the control group, patients in the dexmedetomidine group required 28% less PCA fentanyl during the 24 hours after UAE (P = .006). Numeric rating scale scores for pain (5.0±2.4 vs 7.0±2.2; P = .026) and the need for additional analgesics (two of 25 vs 17 of 25; P<.001) were lower in the dexmedetomidine group than in the control group during the first 1 hour after UAE. The incidence and severity of nausea and vomiting during the 24 hours after UAE were lower in the dexmedetomidine group than in the control group (P < .05).
  
  
  CONCLUSIONS
  The addition of dexmedetomidine infusion to fentanyl PCA provides better analgesia, fentanyl-sparing effect, and less nausea and vomiting, without significant hemodynamic instability.
authors.affiliation: Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 120-752 Seoul, Republic of Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Kim
authors.forename: Chul Ho
authors.initials: CH
authors.lastname: Chang
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Yoon Jae
authors.initials: YJ
authors.lastname: Kim
authors.forename: Man Deuk
authors.initials: MD
authors.lastname: Kim
authors.forename: Dong Woo
authors.initials: DW
authors.lastname: Han
mesh_terms: D062788:Adenomyosis / Q000150:complications / Q000628:therapy*; D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000628:therapy*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D010147:Pain Measurement / Q000187:drug effects; D011292:Premedication / Q000379:methods; D011446:Prospective Studies; D012646:Self Administration; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000009:adverse effects*; D014594:Uterine Neoplasms / Q000150:complications / Q000628:therapy*
chemical_list: D000759:Adjuvants, Anesthesia; D018712:Analgesics, Non-Narcotic; D020927:Dexmedetomidine; D005283:Fentanyl