Naslov
Dexmedetomidine as and adjuvant to levobupivacaine and lidocaine enhences the quality of superficial cervical block for carotid endarterectomy surgery

Autori
Skrtic, Matteo ; Radocaj, Tomislav ; Lijovic, Lada ; Pazur, Iva

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Acta Clin Croat 2022 ; 61(Suppl 1):167 / - , 2022, 167-167

Skup
8 međunarodni stručno-znanstveni skup: Zaštita na radu i zaštita zdravlja

Mjesto i datum
Zagreb, Hrvatska, 02.09.2022. - 03.09.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
regional anaesthesia ; superficial cervical block ; dexmedetomidine ; carotid endarterectomy surgery

Sažetak
Background and goal of study: Numerous additives were tried in combination with local anaesthetics to increase the quality of anaesthesia and prolong postoperative analgesia. Research on use of a-2- receptor agonist dexmedetomidine as an adjuvant in regional anaesthesia has positive effect on duration of block, but there are no studies on usage in superficial cervical block (SCB) in carotid endarterectomy (CEA), where management of mean arterial pressure is essential. We therefore designed a prospective, randomised, double-blinded study to investigate the effect of adding dexmedetomidine to levobupivacaine and lidocaine on the quality of SCB in CEA surgery. Materials and methods: Ultrasound-guided SCB was performed on sixty ASA Grade II and III patients undergoing elective CEA surgery. Patients did not receive any premedication. All patients had invasive blood pressure monitoring and parameters were noted every 5 minutes. Patients were randomly assigned into two groups: both groups received 2 mg/kg 0.5% levobupivacaine with 200 mg of 2% lidocaine supplemented with saline to a volume of 50 mL. Subject group S additionally received 50 micrograms of dexmedetomidine in mixture.The onset and duration of sensory block and analgesia, haemodynamic parameters and side effects: bradycardia, hypotension, respiratory depression, nausea, vomiting, pruritus and shivering were recorded.Results and discussion: Demographic data and surgical characteristics were comparable in both groups. The time to first analgesia was significantly higher in Group S (N=30) vs control Group C (N=30) (median 1080 [IQR 840] vs. 645 [IQR 333]) minutes respectively, Mann-Whitney p=0.002).There was no significant difference in block onset times or duration of sensory block between groups. There was a statistically significant difference in the time to NPRS≥3 between the Subject and Control group [χ2 (1, N=60) = 9.2, p=0.002]. Median times to NPRS≥3 were 677.5 minutes for Control group and 720.0 for Subject group.Conclusion(s): Addition of 50 mcg of dexmedetomidine to 0.5% levobupivacaine and 2% lidocaine for SCB does not increase the duration of SCB, but increases the time to first request of rescue analgesia and increases the probability of NPRS ≤3 in the postoperative period, without influence on haemodynamics and frequency of side- effects.

Izvorni jezik
Engleski

Znanstvena područja
Interdisciplinarne prirodne znanosti, Temeljne medicinske znanosti, Kliničke medicinske znanosti, Integrativna bioetika (prirodne, tehničke, biomedicina i zdravstvo, biotehničke, društvene, humanističke znanosti), Biotehnologija u biomedicini (prirodno područje, biomedicina i zdravstvo, biotehničko područje)

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