Chest Wall Disorder
Conditions
Keywords
Pectus Excavatum
Brief summary
Nowadays, general anaesthesia is carried under balanced anesthesia technique in which many anesthetic adjuvants are used simultaneously, including opioid analgesics in order to reduce the amount of inhalation agents. The most popular adjuvants used are remifentanil, which is an opioid analgesic, and dexmedetomidine. Both of these agents are short acting, can be infused with targeted concentrations, excreted shortly from the body with stable hemodynamics. Remifentanil, when infused for more than 2 hours, causes hyperalgesia to increase the amount of pain postoperatively as well as the amount of opioid analgesics. However, dexmedetomidine does not cause hyperalgesia and is known to have an opioid -sparing effect. In our center. In this study, we aim to compare the effects of remifentanil and dexmedetomidine on postoperative pain in patients undergoing Nuss procedure, which is a very painful operation on the chest wall.
Interventions
DRUGDexmedetomidine
Comparing effects of remifentanil versus dexmedetomidine
Sponsors
Jung Min Koo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Adults aged \>20 2. Patients undergoing Nuss bar operation (pectus excavatum repair surgery) 3. American Society of Anesthesiologists classification I \ III
Exclusion criteria
1. Drug abuse history 2. Chronic pain in need of continuous opioid analgesics administration 3. History of psychiatric diseases 4. Preoperative bradycardia (heart rate \< 50/min) or arrythmia 5. Cardiac diseases other than diabetes or hypertension - coronary artery disease, ischemic heart disease 6. Moderate liver or kidney dysfunction 7. Pregnant or breast feeding women 8. Hypersensitivity to the study drugs 9. Patients who do not agree to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogue Scale | Between 1~6 hours postoperatively. | Pain scale ranges from 0 to 10. 0 means no pain at all, and 10 being the most severe pain anyone can imagine. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Amount of fentanyl used postoperatively at the recovery unit | At 60 minutes after the end of surgery | Amount in micgrograms per wegith in kilograms (migrogram/kilogram) |
| Time needed for postoperative rescue opioid analgesics | At 60 minutes after the end of surgery | — |
| Amount of remifentanil or dexmedetomidine used intraoperatively | Immediately at the end of the surgery | — |
| Intraoperative hemodynamic change: Systolic blood pressure | 1 minute after monitoring (of blood pressure, heart rate, pulse oxymeter and electrocardiogram) starts, when the patient arrives at the operating room | — |
| Amount of postoperative intravenous patient controlled analgesics (PCA) used | At 60 minutes after the end of surgery | — |
| Intraoperative hemodynamic change: mean blood pressure | 1 minute after monitoring (of blood pressure, heart rate, pulse oxymeter and electrocardiogram) starts, when the patient arrives at the operating room | — |
| Intraoperative hemodynamic change: heart rate | 30 minutes after the induction of anesthesia | — |
| Rescue drugs (inotropics or vasopressors) used in order to correct hypotension or bradycardia | Intraoperatively | — |
| Postoperative complications | Between 1~6 hours postoperatively | Number of events that happened to the patient: e.g. Yes or No, and how many times. Nausea/vomiting, hypotension, respiratory depression, urinary retension, dizziness, transient cease in use of intravenous patient controlled analgesics (PCA) |
| Intraoperative hemodynamic change: Diastolic blood pressure | 1 minute after monitoring (of blood pressure, heart rate, pulse oxymeter and electrocardiogram) starts, when the patient arrives at the operating room | — |
Countries
South Korea
Outcome results
None listed