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Dexmedetomidine in combination with morphine PCA provides superior analgesia for shockwave lithotripsy.
Can J Anaesth. 2004 Apr; 51(4):342-7.CJ

Abstract

PURPOSE

To compare the analgesic effects of dexmedetomidine/morphine with those of tramadol/midazolam in patients undergoing extracorporeal shockwave lithotripsy (ESWL) for urinary calculi.

METHODS

Sixty patients were randomized to receive either dexmedetomidine 1 micro g*kg(-1) iv followed by 0.5 micro g*kg(-1)*hr(-1) infusion together with morphine patient-controlled analgesia [(PCA); 2 mg bolus, five minutes lockout, 2 mg*hr(-1) infusion; (Group DEX)], or tramadol 1.5 mg*kg(-1) pre-mixed with midazolam 30 micro g*kg(-1) iv followed by tramadol PCA [20 mg bolus, five minute lockout, 20 mg*hr(-1) infusion; (Group TRA)]. Pain was assessed at baseline and every 15 min thereafter. Patients' and urologist's satisfaction with analgesia and sedation were determined on a seven-point scale ranging from 1 (extremely dissatisfied) to 7 (extremely satisfied). Patient's discharge time was also documented.

RESULTS

Visual analogue scale scores over time were consistently lower in Group DEX compared with Group TRA (P = 0.001). Patients' satisfaction with analgesia (5 +/- 1 vs 4 +/- 2, P = 0.012) and with sedation (6 +/- 1 vs 5 +/- 1, P = 0.020), and urologist's satisfaction (6 +/- 1 vs 4 +/- 2, P = 0.001) were all higher amongst Group DEX patients compared with Group TRA. There was no difference between discharge times of patients in Group DEX compared with those in Group TRA [85 (60,115) min vs 65 (40,95) min, P = 0.069].

CONCLUSION

Dexmedetomidine in combination with morphine PCA provided better analgesia for ESWL and was associated with higher patients' and urologist's satisfaction when compared with a tramadol/midazolam PCA combination.

Authors+Show Affiliations

Department of Anesthesia and Critical Care Medicine, King Abdulaziz University, King Abdulaziz University Hospital, Jeddah, Saudi Arabia. jalhashemi@kaau.edu.saNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15064262

Citation

Alhashemi, Jamal A., and Abdullah M. Kaki. "Dexmedetomidine in Combination With Morphine PCA Provides Superior Analgesia for Shockwave Lithotripsy." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 51, no. 4, 2004, pp. 342-7.
Alhashemi JA, Kaki AM. Dexmedetomidine in combination with morphine PCA provides superior analgesia for shockwave lithotripsy. Can J Anaesth. 2004;51(4):342-7.
Alhashemi, J. A., & Kaki, A. M. (2004). Dexmedetomidine in combination with morphine PCA provides superior analgesia for shockwave lithotripsy. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 51(4), 342-7.
Alhashemi JA, Kaki AM. Dexmedetomidine in Combination With Morphine PCA Provides Superior Analgesia for Shockwave Lithotripsy. Can J Anaesth. 2004;51(4):342-7. PubMed PMID: 15064262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dexmedetomidine in combination with morphine PCA provides superior analgesia for shockwave lithotripsy. AU - Alhashemi,Jamal A, AU - Kaki,Abdullah M, PY - 2004/4/6/pubmed PY - 2004/10/8/medline PY - 2004/4/6/entrez SP - 342 EP - 7 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 51 IS - 4 N2 - PURPOSE: To compare the analgesic effects of dexmedetomidine/morphine with those of tramadol/midazolam in patients undergoing extracorporeal shockwave lithotripsy (ESWL) for urinary calculi. METHODS: Sixty patients were randomized to receive either dexmedetomidine 1 micro g*kg(-1) iv followed by 0.5 micro g*kg(-1)*hr(-1) infusion together with morphine patient-controlled analgesia [(PCA); 2 mg bolus, five minutes lockout, 2 mg*hr(-1) infusion; (Group DEX)], or tramadol 1.5 mg*kg(-1) pre-mixed with midazolam 30 micro g*kg(-1) iv followed by tramadol PCA [20 mg bolus, five minute lockout, 20 mg*hr(-1) infusion; (Group TRA)]. Pain was assessed at baseline and every 15 min thereafter. Patients' and urologist's satisfaction with analgesia and sedation were determined on a seven-point scale ranging from 1 (extremely dissatisfied) to 7 (extremely satisfied). Patient's discharge time was also documented. RESULTS: Visual analogue scale scores over time were consistently lower in Group DEX compared with Group TRA (P = 0.001). Patients' satisfaction with analgesia (5 +/- 1 vs 4 +/- 2, P = 0.012) and with sedation (6 +/- 1 vs 5 +/- 1, P = 0.020), and urologist's satisfaction (6 +/- 1 vs 4 +/- 2, P = 0.001) were all higher amongst Group DEX patients compared with Group TRA. There was no difference between discharge times of patients in Group DEX compared with those in Group TRA [85 (60,115) min vs 65 (40,95) min, P = 0.069]. CONCLUSION: Dexmedetomidine in combination with morphine PCA provided better analgesia for ESWL and was associated with higher patients' and urologist's satisfaction when compared with a tramadol/midazolam PCA combination. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/15064262/Dexmedetomidine_in_combination_with_morphine_PCA_provides_superior_analgesia_for_shockwave_lithotripsy_ L2 - https://doi.org/10.1007/BF03018237 DB - PRIME DP - Unbound Medicine ER -