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.
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