Intraoperative Dexmedetomidine Decreases Postoperative Pain after Gastric Endoscopic Submucosal Dissection: A...

Area of Science:

• Gastroenterology
• Anesthesiology
• Pain Management

Background:

• Postoperative pain is a common complication following gastric endoscopic submucosal dissection (ESD).
• Limited research exists on effective interventions for managing pain after gastric ESD.
• This study investigated the impact of intraoperative dexmedetomidine (DEX) on postoperative pain.

Purpose of the Study:

• To evaluate the efficacy of intraoperative dexmedetomidine (DEX) in reducing postoperative pain after gastric ESD.
• To assess the effect of DEX on morphine consumption, hemodynamic stability, and patient satisfaction.

Main Methods:

• A prospective randomized controlled trial involving 60 patients undergoing gastric ESD.
• Patients were randomized to receive either DEX or a placebo (normal saline) during general anesthesia.
• Postoperative pain was measured using the Visual Analog Scale (VAS), with secondary outcomes including morphine dosage and adverse events.

Main Results:

• The incidence of moderate to severe postoperative pain was significantly lower in the DEX group (27%) compared to the control group (53%).
• VAS pain scores and morphine requirements were significantly reduced in the DEX group.
• While intraoperative hypotension decreased, postoperative hypotension and ephedrine use increased in the DEX group. Postoperative nausea and vomiting scores were also lower.

Conclusions:

• Intraoperative dexmedetomidine (DEX) effectively reduces postoperative pain intensity after gastric ESD.
• DEX administration led to decreased morphine usage and reduced severity of postoperative nausea and vomiting.
• No significant differences were observed in PACU stay, hospital duration, or patient satisfaction.