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Suzuki T, Inokuchi R, Hanaoka K, et al. Dexmedetomidine use during epiduroscopy reduces fentanyl use and postoperative nausea and vomiting: A single-center retrospective study. SAGE Open Med. 2018;6:2050312118756804doi: 10.1177/2050312118756804.
Suzuki, T., Inokuchi, R., Hanaoka, K., Suka, M., & Yanagisawa, H. (2018). Dexmedetomidine use during epiduroscopy reduces fentanyl use and postoperative nausea and vomiting: A single-center retrospective study. SAGE open medicine, 62050312118756804. https://doi.org/10.1177/2050312118756804
Suzuki, Takashi, et al. "Dexmedetomidine use during epiduroscopy reduces fentanyl use and postoperative nausea and vomiting: A single-center retrospective study." SAGE open medicine vol. 6 (2018): 2050312118756804. doi: https://doi.org/10.1177/2050312118756804
Suzuki T, Inokuchi R, Hanaoka K, Suka M, Yanagisawa H. Dexmedetomidine use during epiduroscopy reduces fentanyl use and postoperative nausea and vomiting: A single-center retrospective study. SAGE Open Med. 2018 Feb 09;6:2050312118756804. doi: 10.1177/2050312118756804. eCollection 2018. PMID: 29449944; PMCID: PMC5808957.
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SAGE Open Med. 2018 Feb 09;6:2050312118756804. doi: 10.1177/2050312118756804. eCollection 2018.

Dexmedetomidine use during epiduroscopy reduces fentanyl use and postoperative nausea and vomiting: A single-center retrospective study.

SAGE open medicine

Takashi Suzuki, Ryota Inokuchi, Kazuo Hanaoka, Machi Suka, Hiroyuki Yanagisawa

Affiliations

  1. Department of Anesthesiology and Pain Relief Center, JR Tokyo General Hospital, Tokyo, Japan.
  2. Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan.
  3. Department of Emergency and Critical Care Medicine, JR Tokyo General Hospital, Tokyo, Japan.
  4. Department of Acute Medicine, The University of Tokyo Hospital, Tokyo, Japan.

PMID: 29449944 PMCID: PMC5808957 DOI: 10.1177/2050312118756804

Abstract

OBJECTIVES: Minimally invasive epiduroscopy has recently been reported as an effective treatment procedure for chronic and intractable low back pain. However, no study has determined safe anesthetics for monitored anesthesia care during epiduroscopy. We aimed to compare and evaluate conventional monitored anesthesia care drugs with dexmedetomidine.

METHODS: A retrospective study including all patients who underwent epiduroscopy at the JR Tokyo General Hospital from April 2011 to March 2016 was designed. The epiduroscopy procedures were performed under anesthesia with dexmedetomidine plus fentanyl (dexmedetomidine group) or droperidol plus fentanyl (neuroleptanalgesia group). Patients who received analgesics other than fentanyl, another analgesic combined with fentanyl, any sedative other than dexmedetomidine or droperidol, or who had incomplete data were excluded. We compared (1) the type and dose of medication during the epiduroscopy and (2) the incidence of postoperative nausea and vomiting.

RESULTS: We identified 45 patients (31 and 14 in the dexmedetomidine and neuroleptanalgesia groups, respectively) with a mean age of 69.0 years. The two groups had comparable characteristics, such as age, sex, body mass index, the American Society of Anesthesiologists Physical Status, analgesics used in the clinic, comorbidities, history of smoking, and the duration of anesthesia. The dexmedetomidine group received a significantly lower fentanyl dose during surgery (126 ± 14 vs 193 ± 21 µg, mean ± standard deviation, p = 0.014) and exhibited a significantly lower incidence of postoperative nausea and vomiting (1 vs 3, p = 0.047) than the neuroleptanalgesia group.

CONCLUSION: This study involved elderly patients, and the use of dexmedetomidine in monitored anesthesia care during epiduroscopy procedures in these patients may reduce the required fentanyl dose during surgery and the incidence of postoperative nausea and vomiting. This strategy may help prevent respiratory depression and aspiration.

Keywords: Spinal canal endoscopy; droperidol; low back pain; neuroleptanalgesia; respiratory depression

Conflict of interest statement

Declaration of conflicting interest: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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