Dexmedetomidine combined with oxycodone for perioperative adjuvant analgesia in patients undergoing open pancreaticoduodenectomy:a randomized controlled clinical trial
Objective To investigate dexmedetomidine for perioperative adjuvant analgesia in patients undergoing open pancreaticoduodenectomy.Methods A randomized,double-blind,parallel control and non-inferior clinical trial was conducted between January 2020 and December 2021,232 patients undergoing open pancreaticoduodenectomy were enrolled.There were 116 patients receiving oxycodone for perioperative adjuvant analgesia(OXY group),while another 116 patients receiving oxycodone plus dexmedetomidine(DEX group).The visual analogue scale(VAS)of the patients was observed at 48 h after operation in motion as primary index;while perioperative dose of analgesic drugs,postoperative Ramsay sedation score,hemodynamic parameters during tumor resection and postoperative extubation and postoperative adverse reactions and satisfaction of patients were observed as secondary indexes.Results Compared with OXY group,DEX group had lower VAS scores at rest and at 48 h after operation in motion than OXY group(P＜0.01).Less analgesic drugs were used in DEX group during the perioperative period(P＜0.01).The DEX group had better sedation than the OXY group postoperatively(P＜0.01);DEX group had lower heart rate and mean arterial pressure during operation and during extubation(P＜0.01);the incidence of nausea and vomiting during surgery was lower in the DEX group than that in the OXY group,and the satisfaction rate was higher than OXY group(P＜0.05).Conclusion Dexmedetomidine has a good adjuvant analgesic and sedative effect in the perioperative period of open pancreatoduodenectomy,which can reduce the dose of opioids used during the perioperative period,with less side effects and higher safety.
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