Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Sebelas Maret University/Dr. Moewardi General Hospital, Surakarta, Indonesia
BibTex Citation Data :
@article{JAI62008, author = {Purwoko Purwoko and Andy Nugroho and Sugeng Budi Santoso and RTH Supraptomo and Eko Setijanto and Heri Purnomo and Ardana Arianto and Muhammad Thamrin and Arif Hananto}, title = {The Effects of Dexmedetomidine As an Adjuvant with Levobupivacaine To Epidural Analgesia on The Outcomes of Patients Undergoing Total Abdominal Hysterectomy Surgery}, journal = {JAI (Jurnal Anestesiologi Indonesia)}, volume = {16}, number = {1}, year = {2024}, keywords = {dexmedetomidine; epidural anesthesia; fentanyl; levobupivacaine; total abdominal hysterectomy}, abstract = { Background: Total abdominal hysterectomy (TAH) characterizes as major surgery with increased risk of morbidity. It depends on adequate pain management intra- and postoperatively. Anesthesia management of TAH widely uses a regional approach with the epidural technique which administers a local anesthesia agent into the epidural space. Objective: This study aims to determine the effectiveness of epidural levobupivacaine with fentanyl versus levobupivacaine with dexmedetomidine for epidural anesthesia in patients undergoing TAH. Methods: This is a prospective, single-blinded trial conducted among 20 patients aged 18 to 40 years who underwent elective TAH with American Society of Anesthesiologist (ASA) class I and II status. The control group received epidural levobupivacaine 0.5% with fentanyl as an adjuvant, while the dexmedetomidine group received levobupivacaine 0.5% with dexmedetomidine as an adjuvant. We then compared the degree of pain using a numeric rating scale (NRS) 24 hours after surgery, duration of analgesia, and incidence of postoperative nausea and vomiting (PONV) in both groups. Result: Duration of analgesia was 89.60 + 7.6332 min in group dexmedetomidine, while it was 78.0 + 10.4562 min in group fentanyl, respectively (P < 0.05). The means of NRS was 3.00 + 1.88562 in group dexmedetomidine and 4.80 + 1.1352 in group fentanyl (p=0.019). The incidence of PONV in group dexmedetomidine was three, while in group fentanyl was eight (p=0.025). Conclusion: Dexmedetomidine is preferred over fentanyl when added to levobupivacaine for epidural analgesia in TAH procedures. Dexmedetomidine offers superior quality with a prolonged duration of analgesia, lower NRS values, and a lower incidence of PONV rather than fentanyl. }, issn = {2089-970X}, pages = {26--33} doi = {10.14710/jai.v16i1.62008}, url = {https://ejournal.undip.ac.id/index.php/janesti/article/view/62008} }
Refworks Citation Data :
Background: Total abdominal hysterectomy (TAH) characterizes as major surgery with increased risk of morbidity. It depends on adequate pain management intra- and postoperatively. Anesthesia management of TAH widely uses a regional approach with the epidural technique which administers a local anesthesia agent into the epidural space.
Objective: This study aims to determine the effectiveness of epidural levobupivacaine with fentanyl versus levobupivacaine with dexmedetomidine for epidural anesthesia in patients undergoing TAH.
Methods: This is a prospective, single-blinded trial conducted among 20 patients aged 18 to 40 years who underwent elective TAH with American Society of Anesthesiologist (ASA) class I and II status. The control group received epidural levobupivacaine 0.5% with fentanyl as an adjuvant, while the dexmedetomidine group received levobupivacaine 0.5% with dexmedetomidine as an adjuvant. We then compared the degree of pain using a numeric rating scale (NRS) 24 hours after surgery, duration of analgesia, and incidence of postoperative nausea and vomiting (PONV) in both groups.
Result: Duration of analgesia was 89.60 + 7.6332 min in group dexmedetomidine, while it was 78.0 + 10.4562 min in group fentanyl, respectively (P < 0.05). The means of NRS was 3.00 + 1.88562 in group dexmedetomidine and 4.80 + 1.1352 in group fentanyl (p=0.019). The incidence of PONV in group dexmedetomidine was three, while in group fentanyl was eight (p=0.025).
Conclusion: Dexmedetomidine is preferred over fentanyl when added to levobupivacaine for epidural analgesia in TAH procedures. Dexmedetomidine offers superior quality with a prolonged duration of analgesia, lower NRS values, and a lower incidence of PONV rather than fentanyl.
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