title: Comparison of an Intraoperative Infusion of Dexmedetomidine, Fentanyl, and Remifentanil on Perioperative Hemodynamics, Sedation Quality, and Postoperative Pain Control.
abstract: We aimed to compare fentanyl, remifentanil and dexmedetomidine with respect to hemodynamic stability, postoperative pain control and achievement of sedation at the postanesthetic care unit (PACU). In this randomized double-blind study, 90 consecutive total laparoscopic hysterectomy patients scheduled for elective surgery were randomly assigned to receive fentanyl (1.0 μg/kg) over 1 minute followed by a 0.4 μg/kg/hr infusion (FK group, n = 30), or remifentanil (1.0 μg/kg) over 1 minute followed by a 0.08 μg/kg/min infusion (RK group, n = 30), or dexmedetomidine (1 μg/kg) over 10 minutes followed by a 0.5 μg/kg/hr infusion (DK group, n = 30) initiating at the end of main procedures of the operation to the time in the PACU. A single dose of intravenous ketorolac (30 mg) was given to all patients at the end of surgery. We respectively evaluated the pain VAS scores, the modified OAA/S scores, the BIS, the vital signs and the perioperative side effects to compare the efficacy of fentanyl, remifentanil and dexmedetomidine. Compared with other groups, the modified OAA/S scores were significantly lower in DK group at 0, 5 and 10 minutes after arrival at the PACU (P < 0.05), whereas the pain VAS and BIS were not significantly different from other groups. The blood pressure and heart rate in the DK group were significantly lower than those of other groups at the PACU (P < 0.05). DK group, at sedative doses, had the better postoperative hemodynamic stability than RK group or FK group and demonstrated a similar effect of pain control as RK group and FK group with patient awareness during sedation in the PACU. (World Health Organization registry, KCT0001524).
authors: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Jin Woo
authors: http://orcid.org/0000-0002-7290-0361
authors: JW
authors: Choi
authors: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Jin Deok
authors: http://orcid.org/0000-0002-4365-7091
authors: JD
authors: Joo
authors: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Dae Woo
authors: http://orcid.org/0000-0003-2553-8133
authors: DW
authors: Kim
authors: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Jang Hyeok
authors: http://orcid.org/0000-0001-6206-0103
authors: JH
authors: In
authors: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: So Young
authors: http://orcid.org/0000-0003-0249-4190
authors: SY
authors: Kwon
authors: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Kwonhui
authors: http://orcid.org/0000-0002-3965-7603
authors: K
authors: Seo
authors: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Donggyu
authors: http://orcid.org/0000-0001-7126-2698
authors: D
authors: Han
authors: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors: Ga Young
authors: http://orcid.org/0000-0002-2985-3897
authors: GY
authors: Cheon
authors: Department of Anesthesiology and Pain Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea. flood1@naver.com.
authors: Hong Soo
authors: http://orcid.org/0000-0002-6812-1955
authors: HS
authors: Jung
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects; D006339:Heart Rate; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy*; D010880:Piperidines / Q000008:administration & dosage* / Q000009:adverse effects; D000077208:Remifentanil; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D010880:Piperidines; D020927:Dexmedetomidine; D000077208:Remifentanil; D005283:Fentanyl
keywords: Dexmedetomidine; Fentanyl; Hemodynamic Stability; Pain Control; Remifentanil; Surgery