Evaluating sedative effects of dexmedetomidine and morphine in the patients with opioid use disorder undergoing cataract surgery.

IF 1.4 Q4 IMMUNOLOGY American journal of clinical and experimental immunology Pub Date : 2021-02-15 eCollection Date: 2021-01-01
Dariush Moradi Farsani, Keyvan Ghadimi, Raana Abrishamkar, Kamran Montazeri, Alireza Peyman
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Abstract

Background: Considering that patients with opioid dependence are at higher risk of inadequate sedation during operations, and the rescue analgesia in these patients are usually greater than the general population; the aim of this study was comparison of sedation quality of dexmedetomidine and morphine in patients with opioid use disorder undergoing cataract surgery.

Methods: This clinical trial was conducted on 60 patients with opioid use disorder underwent cataract surgery that were referred to Feiz Hospital, Isfahan, Iran in 2018. Patients were randomly divided into two groups as the dexmedetomidine group started 1 μg/kg dexmedetomidine in 10 minutes before surgery and then continued with 0.5 μg/kg/h while the morphine group received 0.1 mg/kg of morphine before surgery. Sedation score, pain intensity, hemodynamic parameters, analgesic request and side effects were compared in the two groups.

Results: There was no significant differences between groups based on Ramsay score before, during and after surgery (P > 0.05), the pain intensity in the morphine group was significantly lower during the recovery period than dexmedetomidine group, the duration of recovery and sedation in the morphine group was significantly more than the dexmedetomidine group, and nausea and vomiting and eye pain in the morphine group were significantly higher than dexmedetomidine (P < 0.05).

Conclusion: Morphine usage was more effective in pain relief than dexmedetomidine in patients with opioid use disorder undergoing cataract surgery, but the complications and recovery time were higher in morphine usage. Also the sedation was similar in both groups.

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评价右美托咪定和吗啡在阿片类药物使用障碍白内障手术患者中的镇静作用。
背景:考虑到阿片类药物依赖患者术中镇静不充分的风险较高,且该类患者的抢救镇痛往往大于一般人群;本研究的目的是比较右美托咪定和吗啡在阿片类药物使用障碍白内障手术患者中的镇静质量。方法:对2018年转介至伊朗伊斯法罕菲兹医院行白内障手术的60例阿片类药物使用障碍患者进行临床试验。将患者随机分为两组,右美托咪定组术前10分钟开始给予右美托咪定1 μg/kg,术后继续给予0.5 μg/kg/h,吗啡组术前给予0.1 mg/kg吗啡。比较两组患者的镇静评分、疼痛强度、血流动力学参数、镇痛要求及不良反应。结果:各组术前、术中、术后Ramsay评分差异无统计学意义(P > 0.05),吗啡组恢复期疼痛强度显著低于右美托咪定组,吗啡组恢复期疼痛持续时间及镇静时间显著高于右美托咪定组,恶心呕吐及眼痛发生率显著高于右美托咪定组(P < 0.05)。结论:吗啡对阿片类药物使用障碍白内障手术患者疼痛的缓解效果优于右美托咪定,但吗啡的并发症和恢复时间较高。两组的镇静效果相似。
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