Effects of Dexmedetomidine Combined with Sufentanil on Postoperative Delirium in Young Patients After General Anesthesia
Lian Liu, Quan Yuan, Yafeng Wang, Wenwei Gao, Jiabao Hou, Yang Wu, Bo Zhao, Zhongyuan Xia
Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China (mainland)
Med Sci Monit 2018; 24:8925-8932
Chinese Clinical Trial Registry # OOC-16007782
This study was designed to evaluate the effects of combined usage of dexmedetomidine (DEX) and sufentanil on young patients with postoperative delirium (POD) after general anesthesia.
MATERIAL AND METHODS: We randomized 100 young patients with POD into 4 groups: Group D, Group S, Group DS1, and Group DS2, with loading and maintenance doses of DEX and/or sufentanil administered according to the experimental protocol. Hemodynamic variables, standard visual analogue scale (VAS) scores, sedation agitation scale (SAS) scores, stress hormones, and inflammatory biomarkers were assessed at 5 time-points: baseline (T1); 1 h (T2), 2 h (T3), 4 h (T4), and 8 h (T5) after completion of the loading dose.
RESULTS: At T3–T5, hemodynamic indicators in group D were obviously higher than in the other groups (P<0.05). At T2–T5, the VAS and SAS scores were noticeably lower than those at T1 in each group (P<0.05). The VAS and SAS scores were remarkably higher in group D than those in the other groups (P<0.05). Compared with DS1, the incidence of respiratory distress decreased and the incidence of POD increased in group DS2. Compared to T1, plasma concentrations of epinephrine, norepinephrine, IL-6, and TNF-a all decreased at T2 and T5 (P<0.05).
CONCLUSIONS: DEX and sufentanil decrease the incidence of POD, ameliorate the abnormities of hemodynamic indicators, and decrease VAS scores, SAS scores, stress hormones, and inflammatory biomarkers, but increase the incidence of respiratory distress. DEX combined with sufentanil may play a synergistic reaction in causing respiratory distress, but remarkably decreases the incidence of POD.
Keywords: Delirium, dexmedetomidine, Pain, Sufentanil, young adult