title: Sex Differences in the Morphine-Sparing Effects of Intraoperative Dexmedetomidine in Patient-Controlled Analgesia Following General Anesthesia: A Consort-Prospective, Randomized, Controlled Clinical Trial.
abstract: Previous studies have reported that intraoperative dexmedetomidine has morphine-sparing effects in patient-controlled analgesia (PCA). The present study was designed to investigate the possible sex differences in the morphine-sparing effects of intraoperative dexmedetomidine following general anesthesia. A total of 223 patients scheduled for surgeries under general anesthesia were divided into female and male groups. Each group was then subdivided into 2 subgroups that were maintained using propofol/remifentanil/dexmedetomidine (PRD) or propofol/remifentanil/saline (PRS). During the first 24 hours postsurgery, both female and male PRD patients had lower scores on a visual analog scale (VAS) (fPRS vs fPRD, P < 0.05 or P < 0.01; mPRS mPRD, P < 0.05, P < 0.01, or P < 0.001) and consumed less morphine than their controls from the PRS group (fPRS vs fPRD, P = 0.0392; mPRS vs mPRD, P = 0.0041). Interestingly, the female PRD patients had similar VAS scores (fPRD vs mPRD, P > 0.05) and consumed comparable morphine compared to the male PRD patients (fPRD vs mPRD, P = 0.4238). However, when normalized to body weight, they consumed much more morphine than male PRD patients (fPRD vs mPRD, P < 0.001), and this effect was not seen in the PRS patients. Intraoperative administration of dexmedetomidine appeared to have a stronger morphine-sparing effect in controlling postoperative acute pain in male patients than in female patients.
authors.affiliation: From the Department of Anesthesiology (Y-YL), Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, P.R. China, and Department of Anesthesiology (D-JG, J-YL, BQ), Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, P.R. China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Li
authors.forename: Dong-Jian
authors.initials: DJ
authors.lastname: Ge
authors.forename: Jin-Yu
authors.initials: JY
authors.lastname: Li
authors.forename: Bin
authors.initials: B
authors.lastname: Qi
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010880:Piperidines; D015742:Propofol; D000077208:Remifentanil; D012737:Sex Factors
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D018686:Anesthetics, Intravenous; D010880:Piperidines; D020927:Dexmedetomidine; D009020:Morphine; D000077208:Remifentanil; D015742:Propofol