Comparison of the efficacy of dexmedetomidine plus fentanyl patient-controlled analgesia with fentanyl patient-controlled analgesia for pain control in uterine artery embolization for symptomatic fibroid tumors or adenomyosis

A prospective, randomized study

So Yeon Kim, Chul Ho Chang, Jong Seok Lee, Yoon Jae Kim, ManDeuk Kim, Dong Woo Han

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: To investigate whether dexmedetomidine infusion could reduce opioid consumption and opioid-related side effects after uterine artery embolization (UAE). Materials and Methods: Fifty patients undergoing UAE for symptomatic leiomyomas or adenomyosis were randomized into two groups. In 25 patients, dexmedetomidine infusion was started at 0.2 μg/kg/h at 30 minutes before the procedure, followed by 0.4 μg/kg/h for 6 hours after the procedure. In another 25 patients (control group), volume-matched normal saline solution was administered. Both groups received fentanyl-based intravenous patient-controlled analgesia (PCA; fentanyl 10 μg/h with a bolus dose of 20 μg) during the 24 hours after the procedure. Nonspherical polyvinyl alcohol particles were used. Pain scores, fentanyl consumption, need for additional analgesics, and side effects were assessed for 24 hours after UAE. Results: Compared with the control group, patients in the dexmedetomidine group required 28% less PCA fentanyl during the 24 hours after UAE (P =.006). Numeric rating scale scores for pain (5.0±2.4 vs 7.0±2.2; P =.026) and the need for additional analgesics (two of 25 vs 17 of 25; P<.001) were lower in the dexmedetomidine group than in the control group during the first 1 hour after UAE. The incidence and severity of nausea and vomiting during the 24 hours after UAE were lower in the dexmedetomidine group than in the control group (P <.05). Conclusions: The addition of dexmedetomidine infusion to fentanyl PCA provides better analgesia, fentanyl-sparing effect, and less nausea and vomiting, without significant hemodynamic instability.

Original languageEnglish
Pages (from-to)779-786
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume24
Issue number6
DOIs
Publication statusPublished - 2013 Jun 1

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Uterine Artery Embolization
Adenomyosis
Dexmedetomidine
Patient-Controlled Analgesia
Leiomyoma
Fentanyl
Prospective Studies
Pain
Control Groups
Passive Cutaneous Anaphylaxis
Nausea
Opioid Analgesics
Vomiting
Analgesics
Polyvinyl Alcohol
Sodium Chloride
Analgesia
Hemodynamics
Incidence

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{3ada49ff161844c8a33f1fcc562ab889,
title = "Comparison of the efficacy of dexmedetomidine plus fentanyl patient-controlled analgesia with fentanyl patient-controlled analgesia for pain control in uterine artery embolization for symptomatic fibroid tumors or adenomyosis: A prospective, randomized study",
abstract = "Purpose: To investigate whether dexmedetomidine infusion could reduce opioid consumption and opioid-related side effects after uterine artery embolization (UAE). Materials and Methods: Fifty patients undergoing UAE for symptomatic leiomyomas or adenomyosis were randomized into two groups. In 25 patients, dexmedetomidine infusion was started at 0.2 μg/kg/h at 30 minutes before the procedure, followed by 0.4 μg/kg/h for 6 hours after the procedure. In another 25 patients (control group), volume-matched normal saline solution was administered. Both groups received fentanyl-based intravenous patient-controlled analgesia (PCA; fentanyl 10 μg/h with a bolus dose of 20 μg) during the 24 hours after the procedure. Nonspherical polyvinyl alcohol particles were used. Pain scores, fentanyl consumption, need for additional analgesics, and side effects were assessed for 24 hours after UAE. Results: Compared with the control group, patients in the dexmedetomidine group required 28{\%} less PCA fentanyl during the 24 hours after UAE (P =.006). Numeric rating scale scores for pain (5.0±2.4 vs 7.0±2.2; P =.026) and the need for additional analgesics (two of 25 vs 17 of 25; P<.001) were lower in the dexmedetomidine group than in the control group during the first 1 hour after UAE. The incidence and severity of nausea and vomiting during the 24 hours after UAE were lower in the dexmedetomidine group than in the control group (P <.05). Conclusions: The addition of dexmedetomidine infusion to fentanyl PCA provides better analgesia, fentanyl-sparing effect, and less nausea and vomiting, without significant hemodynamic instability.",
author = "Kim, {So Yeon} and Chang, {Chul Ho} and Lee, {Jong Seok} and Kim, {Yoon Jae} and ManDeuk Kim and Han, {Dong Woo}",
year = "2013",
month = "6",
day = "1",
doi = "10.1016/j.jvir.2013.02.034",
language = "English",
volume = "24",
pages = "779--786",
journal = "Journal of Vascular and Interventional Radiology",
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TY - JOUR

T1 - Comparison of the efficacy of dexmedetomidine plus fentanyl patient-controlled analgesia with fentanyl patient-controlled analgesia for pain control in uterine artery embolization for symptomatic fibroid tumors or adenomyosis

T2 - A prospective, randomized study

AU - Kim, So Yeon

AU - Chang, Chul Ho

AU - Lee, Jong Seok

AU - Kim, Yoon Jae

AU - Kim, ManDeuk

AU - Han, Dong Woo

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Purpose: To investigate whether dexmedetomidine infusion could reduce opioid consumption and opioid-related side effects after uterine artery embolization (UAE). Materials and Methods: Fifty patients undergoing UAE for symptomatic leiomyomas or adenomyosis were randomized into two groups. In 25 patients, dexmedetomidine infusion was started at 0.2 μg/kg/h at 30 minutes before the procedure, followed by 0.4 μg/kg/h for 6 hours after the procedure. In another 25 patients (control group), volume-matched normal saline solution was administered. Both groups received fentanyl-based intravenous patient-controlled analgesia (PCA; fentanyl 10 μg/h with a bolus dose of 20 μg) during the 24 hours after the procedure. Nonspherical polyvinyl alcohol particles were used. Pain scores, fentanyl consumption, need for additional analgesics, and side effects were assessed for 24 hours after UAE. Results: Compared with the control group, patients in the dexmedetomidine group required 28% less PCA fentanyl during the 24 hours after UAE (P =.006). Numeric rating scale scores for pain (5.0±2.4 vs 7.0±2.2; P =.026) and the need for additional analgesics (two of 25 vs 17 of 25; P<.001) were lower in the dexmedetomidine group than in the control group during the first 1 hour after UAE. The incidence and severity of nausea and vomiting during the 24 hours after UAE were lower in the dexmedetomidine group than in the control group (P <.05). Conclusions: The addition of dexmedetomidine infusion to fentanyl PCA provides better analgesia, fentanyl-sparing effect, and less nausea and vomiting, without significant hemodynamic instability.

AB - Purpose: To investigate whether dexmedetomidine infusion could reduce opioid consumption and opioid-related side effects after uterine artery embolization (UAE). Materials and Methods: Fifty patients undergoing UAE for symptomatic leiomyomas or adenomyosis were randomized into two groups. In 25 patients, dexmedetomidine infusion was started at 0.2 μg/kg/h at 30 minutes before the procedure, followed by 0.4 μg/kg/h for 6 hours after the procedure. In another 25 patients (control group), volume-matched normal saline solution was administered. Both groups received fentanyl-based intravenous patient-controlled analgesia (PCA; fentanyl 10 μg/h with a bolus dose of 20 μg) during the 24 hours after the procedure. Nonspherical polyvinyl alcohol particles were used. Pain scores, fentanyl consumption, need for additional analgesics, and side effects were assessed for 24 hours after UAE. Results: Compared with the control group, patients in the dexmedetomidine group required 28% less PCA fentanyl during the 24 hours after UAE (P =.006). Numeric rating scale scores for pain (5.0±2.4 vs 7.0±2.2; P =.026) and the need for additional analgesics (two of 25 vs 17 of 25; P<.001) were lower in the dexmedetomidine group than in the control group during the first 1 hour after UAE. The incidence and severity of nausea and vomiting during the 24 hours after UAE were lower in the dexmedetomidine group than in the control group (P <.05). Conclusions: The addition of dexmedetomidine infusion to fentanyl PCA provides better analgesia, fentanyl-sparing effect, and less nausea and vomiting, without significant hemodynamic instability.

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U2 - 10.1016/j.jvir.2013.02.034

DO - 10.1016/j.jvir.2013.02.034

M3 - Article

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SP - 779

EP - 786

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 6

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