Original scientific paper
https://doi.org/10.2478/acph-2023-0040
Effects of epidurally administered dexmedetomidine and dexamethasone on postoperative pain, analgesic requirements, inflammation, and oxidative stress in thoracic surgery
JASMINKA PERŠEC
; Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia
ANDREJ ŠRIBAR ŠRIBAR
; Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia
MONIKA ILIĆ
; Clinical Department for Anesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Dubrava, Zagreb, Croatia
IVAN MAMIĆ
; University of Zagreb Faculty of Pharmacy and Biochemistry, Department of Pharmacology, Zagreb, Croatia
DOMAGOJ KIFER
ANA-MARIJA DOMIJAN
; University of Zagreb Faculty of Pharmacy and Biochemistry, Department of Pharmaceutical Botany, Zagreb, Croatia
*
ŽELJAN MALEŠ
; University of Zagreb Faculty of Pharmacy and Biochemistry, Department of Pharmaceutical Botany, Zagreb, Croatia
PETRA TURČIĆ
orcid.org/0000-0002-2621-8257
; University of Zagreb Faculty of Pharmacy and Biochemistry, Department of Pharmacology, Zagreb, Croatia
*
* Corresponding author.
Abstract
The aim of this study was to compare the effects of dexmedetomidine and dexamethasone as adjuvants to pre-operative epidural administration of local anesthetic (ropivacaine) in thoracic surgery on the post-operative level of pain, use of analgesics, inflammation, and oxidative stress. The study enrolled 42 patients who underwent elective thoracic surgery in a one-year period at the University Hospital Dubrava (Zagreb, Croatia). Based on a computer-generated randomization list the patients were assigned to the dexmedetomidine (n = 18) or dexamethasone (n = 24) group. Post-operatively, patients of dexmedetomidine group reported lower pain (VAS value 1 h post-surgery, 3.4 ± 2.7 vs. 5.4 ± 1.8, dexmedetomidine vs. dexamethasone, p < 0.01) and had lower analgesic requirements in comparison with dexamethasone group. Thus, dexmedetomidine in comparison with dexamethasone was more efficient in lowering pain and analgesia requirements 24 h after the surgery. On the contrary, dexamethasone had better anti-inflammatory properties (CRP level 24 h post-surgery, 131.9 ± 90.7 vs. 26.0 ± 55.2 mg L–1, dexmedetomidine vs. dexamethasone, p < 0.01). Both dexmedetomidine and dexamethasone exhibited antioxidant effects, however, their antioxidant properties should be further explored. The results of this study improve current knowledge of pain control in thoracic surgery.
Keywords
dexmedetomidine; dexamethasone; thoracotomy; local anesthetic; analgesic efficacy
Hrčak ID:
308543
URI
Publication date:
30.12.2023.
Visits: 614 *