Effect of Intraoperative Infusion of Dexmedetomidine-Remifentanil Combination on Postoperative Pain after Gynecologic Laparoscopy

Abstract

Intraoperative infusion of remifentanil is widely used for postoperative analgesia. However, remifentanil is associated with side effects. Intraoperative infusion of dexmedetomidine may result in less postoperative opioid use. The aim of this study was to evaluate the effect of intraoperative dexmedetomidine and remifentanil infusion on pain after gynecological laparoscopy. Materials and Methods: In this randomized, double-blind clinical trial, 90 patients aged 18-60 years, class I or II, ASA grade and under laparoscopic gynecological surgery under general anesthesia were studied. Before induction of general anesthesia, study solutions in the study group (45 cases) in the form of dexmedetomidine 1 g/kg و and remifentanil 1 µg/kg in normal saline solution 0.9% with a total volume of 50 ml and in placebo patients (45 cases) The normal salon was infused in just 10 minutes and then continued at the same dose every hour until the end of the laparoscopy. Results: Frequency of cases without shoulder (p = 0.001) and abdomen (p = 0.001) pain and score of shoulder (p = 0.001) and abdomen (p = 0.002) pain after surgery in PACU were significantly lower in patients in the study group than the placebo group. The time of first request for analgesia in patients in the study group was longer (p=0.001) and the need for injectable analgesia in these patients was significantly lower than patients in the placebo group (p=0.001). The frequency of hypertension (p=0.001) and tachycardia (p=0.021) during surgery and nausea (p=0.001) and postoperative shivering (p=0.001) in patients in the study group were significantly lower than patients in the placebo group. The level of sedation in PACU was similar in patients in the two study groups.