Efficacy and safety of dexmedetomidine for postoperative analgesia in patients with obstructive jaundice

HE Shan; WANG Yonghui; LU Zhihong

doi:10.13276/j.issn.2097-1656.2025.02.016

Abstract：Objective To investigate the safety and efficacy of dexmedetomidine for postoperative analgesia in patients with obstructive jaundice.Methods Patients with obstructive jaundice undergoing laparotomy were randomly divided into dexmedetomidine group and sufentanil group.Dexmedetomidine group was treated with dexmedetomidine 200 μg+sufentanil 200 μg after surgery for patient-controlled intravenous analgesia(PCIA).Sufentanil group was treated with sufentanil 200 µg for PCIA,and the total amount of PCIA was 100 mL.The background dose for PCIA was 0.015 0 mL/(kg·h-1),and supplementary dose was 0.007 5 mL/kg.The primary endpoint was the actual number of PCIA in patients at 24 h after surgery,while the secondary endpoints included the Visual Analogue Scale(VAS)at rest or at cough at 24 h and 48 h after surgery,the number of effective PCIA at 24 h after surgery,the number of effective PCIA and actual PCIA at 48 h after surgery,the number of rescue analgesia,and the incidence of drowsiness,bradycardia,and nausea and vomiting within 24 and 48 h after surgery.Results The number of actual PCIA and effective PCIA at 24 h after surgery in the dexmedetomidine group was(9.5±8.2)and(8.0±6.4),respectively,which were significantly lower than those in the sufentanil group[(P=0.02,MD(95％CI)=-4.6(-7.4--0.8);P=0.01,MD(95％CI)=-3.9(-5.8--0.2)].The number of actual PCIA and effective PCIA at 48 h in the dexmedetomidine group was also significantly lower than that in the sufentanil group(P＜0.05).There was no significant difference in the VAS scores at rest and cough at 24 and 48 h after surgery between the dexmedetomidine group and the sufentanil group.There was also no difference in the number of rescue analgesia,bradycardia,drowsiness,and nausea and vomiting between the two groups.Conclusion Compared with sufentanil alone for analgesia,dexmedetomidine can be used as an adjunct for postoperative analgesia in patients with obstructive jaundice to improve analgesia without increasing the incidence of adverse effects.