Key result
Dexmedetomidine significantly reduced the intraoperative requirement of fentanyl compared to propofol (50.8 mg vs 82.0 mg, p=0.001) during conscious sedation for inguinal hernia repair.
Why the study?
Does dexmedetomidine reduce the requirement of fentanyl compared to propofol for conscious sedation in adult patients undergoing inguinal hernia repair?
RCT (n=80)
Single-blind
Computer-generated random number table
No
Does dexmedetomidine reduce the requirement of fentanyl compared to propofol for conscious sedation in adult patients undergoing inguinal hernia repair?
Absolute Event Rate: 50.8% vs 82%
p-value: p=0.001
Dexmedetomidine is an effective adjuvant for conscious sedation during inguinal hernia repair, significantly reducing intraoperative fentanyl requirements and postoperative pain compared to propofol, though it slightly prolongs sedation onset and recovery.
Supports dexmedetomidine to limit opioid exposure during conscious sedation; extends RCT evidence for its use in ambulatory hernia repair.
Objective The ideal agents for conscious sedation during ambulatory inguinal hernia repair are still unclear. We aimed to compare the analgesic, sedative, haemodynamic, and side effects of dexmedetomidine with those of propofol in combination with fentanyl for conscious sedation in patients undergoing inguinal hernia repair. Methods Eighty patients undergoing unilateral inguinal hernia repair were prospectively randomized to receive either dexmedetomidine (n = 40) or propofol (n = 40). Dexmedetomidine and propofol dosages were adjusted to maintain the targeted level of sedation. Results After administration of sedative drugs, patients who received dexmedetomidine had a significantly lower heart rate. The intraoperative requirement of fentanyl was significantly lower in patients who received dexmedetomidine compared with patients who received propofol. Administration of dexmedetomidine was associated with a reduced postoperative pain score, longer time for onset of sedation, and a slightly longer recovery time. No serious adverse events occurred in either group. The patients' overall satisfaction score was comparable between the two groups. Conclusion Dexmedetomidine is an effective adjuvant when co-administered with fentanyl for conscious sedation in patients who undergo inguinal hernia repair. Administration of dexmedetomidine decreases the requirement of fentanyl and the pain score, but slightly prolongs the time to sedation and recovery.
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Wang et al. (2017) conducted an RCT in Unilateral inguinal hernia (n=80). Dexmedetomidine vs. Propofol was evaluated on Intraoperative requirement of fentanyl (mg) (p=0.001). Dexmedetomidine significantly reduced the intraoperative requirement of fentanyl compared to propofol (50.8 mg vs 82.0 mg, p=0.001) during conscious sedation for inguinal hernia repair.
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