Key result
Intraoperative dexmedetomidine significantly reduced postoperative nalbuphine consumption compared to magnesium sulfate (33.58 mg vs 40.32 mg) and control (49.06 mg) in patients undergoing VATS.
Why the study?
The study was designed to evaluate the effects of magnesium sulfate infusion compared to dexmedetomidine on postoperative analgesic consumption and pain control in patients undergoing VATS.
Does dexmedetomidine compared to magnesium sulfate improve postoperative pain control and reduce analgesic consumption in patients undergoing VATS?
RCT (n=90)
Double-blind
Computerized program
No
Does dexmedetomidine compared to magnesium sulfate improve postoperative pain control and reduce analgesic consumption in patients undergoing VATS?
Absolute Event Rate: 33.58% vs 49.06%
p-value: p=<0.001
Dexmedetomidine provides superior postoperative analgesia, reduced anesthetic requirements, and better hemodynamic stability compared to magnesium sulfate during VATS, albeit at the cost of prolonged recovery.
May warrant close hemodynamic monitoring with dexmedetomidine in VATS; leaves open analgesic comparisons to magnesium.
Background This study was designed to evaluate the effects of infusion of magnesium sulfate compared to dexmedetomidine on the postoperative analgesic consumption and pain control in patients scheduled for video-assisted thoracoscopic surgeries (VATS). The intraoperative hemodynamics, anesthesia requirements, and recovery profile were also evaluated. Results The mean arterial pressure (MAP) and heart rate (HR) recordings were significantly lower in group D than in groups C and M. The MAP recordings were significantly lower in group M than in group C with no significant difference as regards the HR recordings between both groups. Intraoperative sevoflurane and fentanyl requirements were significantly lower in groups D and M than in group C and in group D than in group M. The atracurium consumption was significantly lower in group M than in groups C and D. The time to reach modified Aldrete score ≥ 9 was significantly longer in groups D and M than in group C and in group D than in group M. Postoperative Ramsay sedation scores were significantly higher in groups D and M than in group C throughout the PACU stay and in group D than in group M in the 1st h postoperatively. The VAS score recordings were significantly lower in groups D and M than in group C and in group D than in group M except at 24-h postoperative recordings. The postoperative nalbuphine and ketorolac requirements were significantly lower in groups D and M than in group C and in group D than in group M. Conclusions During VATS, patients who received dexmedetomidine had better hemodynamic stability, less intraoperative anesthetic consumption with better quality of postoperative analgesia, and less postoperative analgesic consumption but longer postoperative anesthesia recovery and higher postoperative sedation scores compared with magnesium sulfate.
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Menshawi et al. (2022) conducted an RCT in Patients scheduled for video-assisted thoracoscopic surgeries (VATS) (n=90). Dexmedetomidine vs. Magnesium sulfate and normal saline was evaluated on Total postoperative PCA nalbuphine consumption (mg) (p=<0.001). Intraoperative dexmedetomidine significantly reduced postoperative nalbuphine consumption compared to magnesium sulfate (33.58 mg vs 40.32 mg) and control (49.06 mg) in patients undergoing VATS.
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