Comparison of meperidine alone with meperidine plus dexmedetomidine for postoperative patient-controlled analgesia

To investigate if the addition of dexmedetomidine to meperidine in a patient-controlled analgesia (PCA) device would reduce postoperative meperidine consumption when compared with meperidine alone.

Forty patients scheduled for elective abdominal surgery under general anesthesia in Suleyman Demirel University Medical School, Isparta, Turkey between February and September 2006, were randomly allocated into 2 groups. Group I: meperidine 0.25 mg kg-1 intravenous bolus and dexmedetomidine 0.5 mcg kg-1 in 50 ml of saline solution infusion before the end of surgery. Group II: meperidine 0.25 mg kg-1 intravenous bolus and 50 ml of saline solution infusion. In the postanesthesia care unit (PACU) patients in both groups received intravenous meperidine 10 mg with 5-minutes intervals until the patient`s verbal pain score is lower than 2. Patients in both groups received PCA during the 24 hours after surgery (meperidine 5 mg + dexmedetomidine 10 mcg bolus for group I, meperidine 5 mg for group II). The verbal rating score of pain and meperidine requirement is recorded during PACU stay. Meperidine consumption with PCA is recorded until 24 hours postoperatively.

Verbal rating score of pain in the PACU was lower in group I than group II (p<0.05). Meperidine consumption was lower in group I than group II during the PACU stay and until 24 hours postoperatively (p<0.01).

When compared with meperidine PCA, meperidine-dexmedetomidine PCA reduces postoperative meperidine consumption.