20.500.12556/RUL-107647 VPLIV DEKSMEDETOMIDINA IN LIDOKAINA NA OBOPERATIVNO PORABO OPIOIDOV PRI LAPAROSKOPSKIH RESEKCIJAH ČREVESA: RANDOMIZIRANA KONTROLIRANA KLINIČNA RAZISKAVA INFLUENCE OF DEXMEDETOMIDINE AND LIDOCAINE ON PERIOPERATIVE OPIOID CONSUMPTION IN LAPAROSCOPIC INTESTINE RESECTION: A RANDOMIZED CONTROLLED CLINICAL TRIAL Izhodišče: Opioidni analgetiki in analgetiki z drugim mehanizmov delovanja imajo sinergistični učinek. Z njimi lahko zmanjšamo porabo opioidnih analgetikov. Znano je, da deksmedetomidin in lidokain zmanjšata porabo opioidov, vendar vpliv deksmedetomidina na porabo opioidnih analgetikov pri laparoskopskih črevesnih resekcijah še ni bil raziskan. S to raziskavo smo želeli ugotoviti, če uporaba dodanega deksmedetomidina ali lidokaina zmanjša porabo opioidov med in po operaciji. Metode: Med raziskavo smo opazovali: (i) porabo fentanila, (ii) porabo piritramida prvi in drugi dan po operaciji in (iii) spremembo zaznavne sposobnosti glede na vrednosti pred operacijo in nastanek nevropatske bolečine dva meseca po operaciji. 59 bolnikov smo naključno razdelili v tri skupine. Bolnike v kontrolni skupini (CG) smo anestezirali z neprekinjeno infuzijo propofola in odmerki fentanila. Dekmedetomidinski skupini (DG) smo dodali neprekinjeno intravenozno infuzijo dekmedetomidina (0.5 µg/kg/h), lidokainski (LG) pa infuzijo lidokaina (1.5 mg/kg/h). Rezultati: Med skupinami nismo opazili razlik v porabi fentanila. Prvi dan po operaciji smo opazili značilno nižjo porabo piritramida v LG v primerjavi s CG (p=0.019) in drugi dan po operaciji v LG v primerjavi z DG (p=0.003). Skupna poraba piritramida je bila značnilno nižja v LG v primerjavi s CG (p=0.003). Nismo našli razlik v spremembi spoznavne sposobnosti po operaciji glede na vrednosti preoperativno in v nastanku nevropatske bolečine dva meseca po operaciji. Zaključki: Lidokain in deksmedetomidin sta zmanjšala porabo propofola med operacijo, vendar nista zmanjšala porabe fentanila. Lidokain je zmanjšal porabo piritramida po operaciji.   Background: Combination of opioid analgesics and analgesics with different mechanism of action has synergistic analgesic effect and therefore the consumption of opioid analgesics could be decreased. It is known that dexmedetomidine and lidocaine have both opioid sparing effects, but the influence of dexmedetomidine in laparoscopic intestine resections has not been observed yet. In this study we investigated if additional dexmedetomidine or lidocaine can reduce opioid consumption. Methods: Within the study we observed: (i) fentanyl consumption, (ii) consumption of piritramide on the first and the second postoperative day, and (iii) cognitive function before and after the operation and neuropathic pain two months after the operation. 59 participants were randomly allocated into three groups. The anaesthesia type in the control group (CG) was continuous propofol infusion and fentanyl boluses. Continuous intravenous infusion of dexmedetomidine (0.5 µg/kg/h) and lidocaine (1.5 mg/kg/h) was added to dexmedetomidine (DG) and lidocaine group (LG), respectively. Results: There was no reduction in fentanyl consumption among the groups. We noted significantly lower consumption of piritramide in LG compared with CG on the first postoperative day (p=0.019), and in LG compared with DG on the second postoperative day (p=0.003). There were no differences in changes in cognitive function before and after the surgery and appearance of neuropathic pain two months after the surgery. Conclusions: Lidocaine and dexmedetomidine reduced intraoperative propofol consumption but failed to decrease fentanyl demand. Lidocaine reduced piritramide consumption postoperatively. analgezija spoznavna sposobnost deksmedetomidin laparoskopija lidokain nevralgija analgesia cognitive function dexmedetomidine laparoscopy lidocaine neuralgia true false false Slovenski jezik Angleški jezik Doktorsko delo/naloga 2019-05-10 07:15:07 2019-05-10 07:15:14 2022-08-19 03:50:22 0000-00-00 00:00:00 2019 0 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 1970-01-01 11549 324.pdf 324.pdf 1 2F247BDD79C30C38147C1E8B7E4FC18B 564546f1bdd60dc1a7e6d070135355073fa97f34ce4d9b6919ea690b569b8e8c 79cdd179-a1b6-11eb-a523-00155dcfd717 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=118505 Medicinska fakulteta 0 0 0