title: Dexmedetomidine versus morphine infusion following laparoscopic bariatric surgery: effect on supplemental narcotic requirement during the first 24 h.
abstract: The primary aim of this pilot study was to determine whether the dexmedetomidine infusion initiated immediately after laparoscopic bariatric surgery, offers an advantage over a morphine infusion with respect to rescue morphine and paracetamol requirements over the first 24 post-operative hours.
  
  
  
  Sixty morbidly obese adult patients scheduled for laparoscopic bariatric surgery were randomly assigned to receive an infusion of either 0.3 mcg/kg/h dexmedetomidine (Group D) or 3 mg/h Morphine (Group M) for 24 h immediately post-operatively. All patients received standardized general anesthesia and were evaluated and treated for pain in the intensive care unit by providers who were blinded to their treatment group. The primary outcome was the need for supplemental, "rescue" paracetamol (Dolargan. Hikma, Jordan) and morphine titrated to achieve visual analog scales (VAS) of <40 and <70, respectively.
  
  
  
  A total of 60 patients (77 % female, mean age 33.5 years ± 9.5 and body mass index (BMI) 43.0 ± 4.5) were randomized to Group M and 30 to Group D. There were no significant differences in mean rescue paracetamol and morphine requirements. Mean total morphine requirements in Group D were 6.1 ± 3.1 mg, whereas 72.9 ± 2.2 mg in Group M (p < 0.0001).
  
  
  
  An intravenous infusion of dexmedetomidine, initiated and continued for 24 h following laparoscopic bariatric surgery, can decrease the overall morphine requirements during this period. This pilot study demonstrated that the post-operative initiation of dexmedetomidine can be morphine sparing following laparoscopic bariatric surgery.
authors.affiliation: Department of Anesthesia and ICU, Faculty of Medicine, University of Jordan and Jordan University Hospital, Amman, Jordan.
authors.forename: Sami
authors.initials: S
authors.lastname: Abu-Halaweh
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Jordan and Jordan University Hospital, Amman, Jordan.
authors.forename: Firas
authors.initials: F
authors.lastname: Obeidat
authors.affiliation: Department of Anesthesia, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Absalom
authors.affiliation: Department of Anesthesia and ICU, Faculty of Medicine, University of Jordan and Jordan University Hospital, Amman, Jordan.
authors.forename: Abdelkareem
authors.initials: A
authors.lastname: AlOweidi
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Jordan and Jordan University Hospital, Amman, Jordan.
authors.forename: Mahmood Abu
authors.initials: MA
authors.lastname: Abeeleh
authors.affiliation: Department of Anesthesia and ICU, Faculty of Medicine, University of Jordan and Jordan University Hospital, Amman, Jordan.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Qudaisat
authors.affiliation: Statistical Programmer, DM-Stat, Inc., Malden, MA, USA.
authors.forename: Fay
authors.initials: F
authors.lastname: Robinson
authors.affiliation: Department of Anesthesia, Perioperative and Pain Medicine, Harvard Medical School, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA, 02115, USA. keira.mason@childrens.harvard.edu.
authors.forename: Keira P
authors.initials: KP
authors.lastname: Mason
mesh_terms: D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D050110:Bariatric Surgery; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000517:prevention & control; D010865:Pilot Projects; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D020927:Dexmedetomidine; D009020:Morphine
keywords: Adverse events; Quality and outcomes; Sedation