Acta anaesthesiologica Scandinavica
Haemodynamic and Respiratory Effects of Dexmedetomidine as an Adjuvant to Oxycodone Patient-Controlled Analgesia After Lumbar Spinal Fusion: A Post Hoc Analysis of the DoseRespDex Randomised Controlled Trial
By Mäkelä S, Saari TI, Löyttyniemi E and 3 others.
Abstract
Purpose
Dexmedetomidine has been studied as an adjunct to opioid patient-controlled analgesia (PCA) because of its opioid-sparing properties and limited respiratory depression. However, potential dose-dependent haemodynamic effects should be considered, and data on dexmedetomidine administered via PCA remain limited.
Methods
In this post hoc analysis of a randomised, double-blind, placebo-controlled trial, 98 adults undergoing lumbar spinal fusion were randomised 1:1:1:1 to 24-h PCA with oxycodone 1 mg/mL alone (D0; placebo referring to normal saline replacing dexmedetomidine in the PCA syringe) or combined with dexmedetomidine 2.5 μg/mL (D2), 5 μg/mL (D5) or 10 μg/mL (D10). Outcomes of interest for the present analysis included mean arterial pressure (MAP), heart rate (HR), respiratory parameters and adverse events. Plasma dexmedetomidine concentrations were analysed as a pre-planned pharmacokinetic sub-analysis.